Tasman Medical Journal

ISSN:  2652-1881

Category: Research

Assessing the accuracy of discharge coding for gout, using the International Classification of Disease, at two tertiary teaching hospitals in Perth

Clinical and epidemiological research is often conducted using data from hospital discharge coding. The authors have studied the accuracy of a discharge coding diagnosis of gout, compared to clinical diagnoses based on ACR/EULAR 2015 gout classification criteria and case note review. The coding diagnosis was not supported by the former in over half the cases, or by the latter in almost one third.

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Impact of ‘Can’t Intubate Can’t Oxygenate’ (CICO) kit ergonomic design on the timed responses of participants in simulated CICO crises: A randomised, crossover pilot study

IntroductionThe ‘Can’t Intubate Can’t Oxygenate’ (CICO) situation is a life-threatening, time-critical airway emergency.1 Although a rare event, it is associated with significant patient morbidity and mortality.1 The 4th National Audit Project by the Royal College of Anaesthetists (RCOA) and Difficult Airway Society (DAS) highlighted multiple factors influencing CICO outcome.2 A major modifiable factor included the availability and accessibility of essential equipment.2 The purported ergonomic utility of pre-packaged CICO equipment into kits has also been recently described in literature.3 However, there remains a lack of evidence in current literature to support the superiority of any one packaged design or inferences as to its impact on task performance. At Fiona Stanley Hospital, the Vortex approach and Vortex CICO status tool are used for in-theatre emergency airway and CICO crisis management, respectively. As part of the Vortex CICO status tool, there exists a recommendation for the use of a CICO ‘kit’ as part

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Outcomes from the first five years of allogeneic haemopoietic progenitor cell transplantation at Fiona Stanley Hospital

INTRODUCTIONAllogeneic haemopoietic progenitor cell transplantation (alloHPCT) involves the infusion of third party-derived haemopoietic precursor cells into a recipient who has undergone sufficient chemotherapy or radiotherapy conditioning treatment to allow engraftment of these cells and eventually full haemopoietic and immunological reconstitution.  The treatment is effective as replacement of haemopoiesis in bone marrow failure syndromes, and allows high doses of chemotherapy as well as life-long immunological surveillance against relapse to treat malignant conditions.  Donors are preferentially siblings who are human leukocyte antigen (HLA) matched at both class I and II loci, HLA-matched unrelated donors, or alternative donors such as partially matched unrelated adult, related adult or cryopreserved umbilical cord blood products.  In usual circumstances, donor cells are infused ‘fresh’, immediately after collection, into a recipient who has just received conditioning therapy.  Risks to recipients include toxicity of chemotherapy or radiotherapy, infection during aplasia or immunological reconstitution, relapse and graft-versus-host disease.  Western Australia

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An evaluation of research capacity and culture in a sample of Western Australian Allied Health professionals

Introduction Research should be one of the pillars of a resilient flexible health system,1 and building research capacity is crucial for maintaining or improving quality of care and patient outcomes.  Translational research is an important phase of the research process.  Allied Health professionals (AHP) comprise a significant and vital proportion of the Australian healthcare workforce across several professional categories.  Such personnel are uniquely placed to design, generate, and execute clinically meaningful research, and translate it into practice.2,3 However, the literature indicates that the research culture within Allied Health is overshadowed by prioritisation of delivery of clinical services, and is hampered by a number of barriers to engagement (such as lack of time, research skills, and resources) despite an interest in conducting research.4-7 Given evidence that the proportion of edAHP either leading or participating in research is limited, an examination of the factors influencing Allied Health research capacity and culture is

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Trends in acute myeloid leukaemia in Western Australia over time: Improved outcomes with contemporary management

IntroductionReal-world outcomes of acute myeloid leukaemia (AML) are poor compared to the results of clinical trials.  This partially reflects population differences due to patient selection criteria in trials (excluding older and unfit patients who are unsuitable for aggressive treatment), and lack of improvement in the efficacy of intensive chemotherapy over time.  However, there have been successful developments in AML management including improved non-intensive therapies, laboratory diagnostics to stratify patient risk, donor selection for allogeneic stem cell transplantation (allo-SCT) and supportive care.  We have performed a retrospective analysis of all cases of AML in Western Australia from 2009 to 2018 with respect to clinical and laboratory characteristics, treatments and outcomes, compared to a historical cohort. MethodsAML was defined as per the 2016 WHO classification1.  Cases were identified by hospital discharge summary records at 3 tertiary public hospitals in WA and the laboratory cytogenetics records for new diagnoses of AML between 2009

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An audit of clinical service delivery and outcomes in diffuse idiopathic skeletal hyperostosis – preliminary evidence for efficacy of tumour necrosis factor inhibition therapy

IntroductionDiffuse idiopathic skeletal hyperostosis (DISH), also known as Forestier’s disease or ankylosing hyperostosis, is a common skeletal disorder, which is reported to range in frequency from 3.8% of males and 2.6% of females in a Finnish population-based study to 22.4% of males and 13.4% of females in an Israeli hospital-based study.1, 2 The disorder was first described by Forestier, Jacqueline and Rotes-Querol in 1950.3  The skeletal phenotype suggests it is an historically ancient disorder, but the pathophysiology is still poorly understood.  Paleoradiological studies confirm the antiquity of the disease and raise the possibility of familial clustering, which, in turn, suggests a genetic contribution to the aetiology.4 DISH is characterised by irreversible calcification and ossification of the spinal ligaments and entheses.  Although clinically similar to spondyloarthropathies, the two disorders can be distinguished on the basis of their immunogenetic profile and imaging signs, especially in respect to the sacro-iliac (SI) joints, which

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Life AfTER covid-19 (LATER-19): a protocol for a prospective, longitudinal, cohort study of symptoms, physical function and psychological outcomes in the context of a pandemic

IntroductionPatients infected with SARS-CoV-2 (COVID-19 disease) present with respiratory tract infection and symptoms such as fever, cough, fatigue, sputum production and/or breathlessness.1 The spectrum of COVID-19 varies from asymptomatic infection through mild upper respiratory tract illness, to severe and potentially fatal viral pneumonia with respiratory failure. The Chinese Centre for Disease Control and Prevention reported that 70,420 of the 80,928 confirmed cases in China are “cured and discharged from hospital,” while 3,245 have died.2  However, in the early stage of this pandemic, and due mainly to the lack of understanding of the properties of the virus, inadequate medical protection, high infectivity and absence of effective treatment  there was a dramatic increase in the number of patients exceeding medical resources. As a result, the initial patient discharge rate was reported to be relatively low.3 Scientists and health care workers around the world are working to improve treatments in order to reduce

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