Imperial College London
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DrBernardHernandez Perez

Faculty of Medicine, Department of Infectious Disease

Research Fellow
 
 
 
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Location

 

B420Electrical EngineeringSouth Kensington Campus

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Summary

 

Publications

Citation

BibTex format

@article{Ming:2023:10.1186/s12911-023-02116-4,
author = {Ming, D and Nguyen, QH and An, LP and Chanh, HQ and Tam, DTH and Truong, NT and Huy, VX and Hernandez, B and Van, Nuil JI and Paton, C and Georgiou, P and Nguyen, NM and Holmes, A and Tho, PV and Yacoub, S},
doi = {10.1186/s12911-023-02116-4},
journal = {BMC Medical Informatics and Decision Making},
pages = {1--9},
title = {Mapping patient pathways and understanding clinical decision-making in dengue management to inform the development of digital health tools},
url = {http://dx.doi.org/10.1186/s12911-023-02116-4},
volume = {23},
year = {2023}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - BackgroundDengue is a common viral illness and severe disease results in life-threatening complications. Healthcare services in low- and middle-income countries treat the majority of dengue cases worldwide. However, the clinical decision-making processes which result in effective treatment are poorly characterised within this setting. In order to improve clinical care through interventions relating to digital clinical decision-support systems (CDSS), we set out to establish a framework for clinical decision-making in dengue management to inform implementation.MethodsWe utilised process mapping and task analysis methods to characterise existing dengue management at the Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam. This is a tertiary referral hospital which manages approximately 30,000 patients with dengue each year, accepting referrals from Ho Chi Minh city and the surrounding catchment area. Initial findings were expanded through semi-structured interviews with clinicians in order to understand clinical reasoning and cognitive factors in detail. A grounded theory was used for coding and emergent themes were developed through iterative discussions with clinician-researchers.ResultsKey clinical decision-making points were identified: (i) at the initial patient evaluation for dengue diagnosis to decide on hospital admission and the provision of fluid/blood product therapy, (ii) in those patients who develop severe disease or other complications, (iii) at the point of recurrent shock in balancing the need for fluid therapy with complications of volume overload. From interviews the following themes were identified: prioritising clinical diagnosis and evaluation over existing diagnostics, the role of dengue guidelines published by the Ministry of Health, the impact of seasonality and caseload on decision-making strategies, and the potential role of digital decision-support and disease scoring tools.ConclusionsThe study highlights the contemporary priorities i
AU  - Ming,D
AU  - Nguyen,QH
AU  - An,LP
AU  - Chanh,HQ
AU  - Tam,DTH
AU  - Truong,NT
AU  - Huy,VX
AU  - Hernandez,B
AU  - Van,Nuil JI
AU  - Paton,C
AU  - Georgiou,P
AU  - Nguyen,NM
AU  - Holmes,A
AU  - Tho,PV
AU  - Yacoub,S
DO  - 10.1186/s12911-023-02116-4
EP  - 9
PY  - 2023///
SN  - 1472-6947
SP  - 1
TI  - Mapping patient pathways and understanding clinical decision-making in dengue management to inform the development of digital health tools
T2  - BMC Medical Informatics and Decision Making
UR  - http://dx.doi.org/10.1186/s12911-023-02116-4
UR  - https://bmcmedinformdecismak.biomedcentral.com/articles/10.1186/s12911-023-02116-4
UR  - http://hdl.handle.net/10044/1/102809
VL  - 23
ER  -
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