Paediatrics ACF Projects 2020

A list of ACF 2020 projects within the speciality of paediatrics.

Prediction of length of stay in acute care

Prof Tim Coats tc61@le.ac.uk & Dr Damian Roland dr98@le.ac.uk

Digital records in emergency care are resulting in a large novel resource for research. This project will equip an ACF with the skills required to undertake a PhD focussed on Clinical Data Science in Adult or Paediatric Emergency Care, in order to develop an academic career based on the current rapid digitisation of Emergency Care data.

This project will link with the Leicester University Clinical Data Science Initiative and the SmartUHL informatics program within the University Hospitals of Leicester NHS Trust. It will be carried out in conjunction with the University Departments of Mathematics (Prof I Tyukin) and Informatics (Dr G Kefalidou).

The project will build on ongoing work in adult and paediatric emergency care, and will involve the linkage of Emergency Department data with patterns of change in physiology and socio-demographic data in order to identify and then predict segments of the ED population with either very short or very long lengths of stay. Data visualisations for dynamic presentation of the resulting predictive data in emergency care will also be explored using participatory design techniques.

The skills learned during this project will form the basis for an academic career focussed on clinical data science in emergency care.

Volatile organic compounds in the exhaled breath of children with preschool wheeze

Dr Erol Gaillard eag15@le.ac.uk

Approximately one-third of preschool children in the UK develop significant wheezing. There are currently no tests to diagnose asthma in pre-schoolers, and they cannot be reliably phenotyped making treatment decisions difficult.

Analysis of exhaled breath for asthma diagnosis, monitoring and phenotyping offers a non-invasive avenue particularly attractive for development and use in children. Under the umbrella of the East Midlands Breathomics Pathology Node we recently completed a pilot study in preschool children measuring volatile organic compounds (VOCs) using Proton-Transfer-Reaction Mass Spectrometry. We found that the VOC profile in wheezy children was significantly different compared to a healthy control group.

We now want to conduct a larger study to identify specific VOCs associated with preschool wheeze that could be tested for their diagnostic accuracy. We will use forced oscillation, an effort-independent lung function test as a comparator.

We plan to recruit children < 5 years with acute and stable asthma, collect breath for VOC analysis and perform a forced oscillation test. Medium term outcome and response to preventer treatment will be monitored.

Breath analysis is a rapidly developing research field but there are few studies in children. Results from this study will contribute important data in the field of childhood asthma.

Determining the clinically relevant anatomy to teach UG medical students

Dr Steven Jacques sjj22@le.ac.uk

Human Anatomy has been a core component of undergraduate (UG) medical education for many years, and while it continues to be a key theme, the depth of anatomy taught has seen a steady decline. The need for a solid foundation of anatomical knowledge, while more readily appreciated as essential for those pursuing surgical careers, is important for any practicing clinician. Clearly, which areas of anatomy are most relevant will vary depending on the postgraduate speciality. With ever increasing pressures on space within the UG curriculum, there is obvious priority to ensuring what is taught best enables students to meet the demands of the breadth of future clinical practice.

While the GMC do not currently stipulate specific outcomes for the level of anatomy within the UG medical curriculum, the future introduction of the UK Medical Licensing Assessment will likely lead to efforts to better establish ILOs for the basic sciences, as a whole.  In 2016, in response to the lack of consensus and guidance on the appropriate level of anatomy, the Anatomical Society defined a core regional anatomy syllabus of 156 ILOs, which were to help curriculum planners determine the clinically relevant anatomy to teach UG medical students. The proposed ILOs were determined by a Delphi panel of experts, which included surgeons, radiologists and anatomists.

The first step of the project will involve a series of focus groups and surveys with a variety of early clinical trainees from medicine, surgery and primary care. The purpose of this will be to identify whether there are elements of the 156 identified ILOs that represent a base of anatomical knowledge common across a breadth of specialities (surgical and non-surgical). The second step will be to explore how well they perceive (by self-report) to have retained knowledge of those areas of anatomy (identified in the first step of the project).

The findings from this project will help to better define areas of anatomy that are seen as most important, relevant and common to a breadth of clinical specialities. Further work/projects could explore how this anatomy could be prioritised or given greater attention within the UG medical curriculum, or early postgraduate period and whether there are any interventions that can be applied to improve retention of knowledge in those areas.

Education

If you are interested in progressing an educational research project within the specialty please contact Professor Bob Norman who is based in the Leicester Medical School, rin1@le.ac.uk

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