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Biomedical subjects

Christopher Pearce

Publications and source records attributed to Christopher Pearce.

7 recordsLinked to original sources
PubMed2006

Computers can't listen--algorithmic logic meets patient centredness.

The doctor-patient relationship is crucial to the practice of medicine and yet the rise of science in the 19th and 20th centuries shifted doctors' focus away from the patient toward another entity: the disease. Slowly, the medical profession is rediscovering the importance of the doctor-patient relationship. General practice has contributed significantly by developing the patient centred clinical method, and further models have been introduced that take into account both the doctor's and the patient's perspectives. More recent changes in medicine--particularly computerisation and the introduction of evidence based medicine--may once again threaten this emphasis on patient centredness.

Algorithms↗
PubMed2005

Fever in children.

Fever in children is a common presenting problem in general practice, and its assessment and management are steeped in habits and teaching from the past. Evidence now suggests that treating fever is not based on the evidence that we thought--that the use of drugs has little effect both on the course of disease and the wellbeing of the child. What is the evidence for what we do and what we should do, and how do we apply this in our surgeries?

Analgesics, Non-Narcotic↗
PubMed2003

Falls prevention within the Australian general practice data model: methodology, information model, and terminology issues.

The iterative development of the Falls Risk Assessment and Management System (FRAMS) drew upon research evidence and early consumer and clinician input through focus groups, interviews, direct observations, and an online questionnaire. Clinical vignettes were used to validate the clinical model and program logic, input, and output. The information model was developed within the Australian General Practice Data Model (GPDM) framework. The online FRAMS implementation used available Internet (TCP/IP), messaging (HL7, XML), knowledge representation (Arden Syntax), and classification (ICD10-AM, ICPC2) standards. Although it could accommodate most of the falls prevention information elements, the GPDM required extension for prevention and prescribing risk management. Existing classifications could not classify all falls prevention concepts. The lack of explicit rules for terminology and data definitions allowed multiple concept representations across the terminology-architecture interface. Patients were more enthusiastic than clinicians. A usable standards-based online-distributed decision support system for falls prevention can be implemented within the GPDM, but a comprehensive terminology is required. The conceptual interface between terminology and architecture requires standardization, preferably within a reference information model. Developments in electronic decision support must be guided by evidence-based clinical and information models and knowledge ontologies. The safety and quality of knowledge-based decision support systems must be monitored. Further examination of falls and other clinical domains within the GPDM is needed.

Accidental Falls↗
PubMed2003

Screening protocols for group B streptococcus: are transport media appropriate?

OBJECTIVE: To evaluate group B streptococcus (GBS) detection in an in vitro setting, using a low and controlled inoculum from swabs directly inoculated into a selective medium, as compared to delayed inoculation following a period in a commercial Amies transport medium with charcoal (Venturi Transystem Copan, Italy). STUDY DESIGN: Clinical isolates of GBS (n = 103), were inoculated into the Amies transport medium with charcoal in a concentration of 100 colony-forming units (cfu)/ml (10 cfu/swab). Swabs were then transferred to an enrichment broth (NPC) at time intervals of 0, 2, 4, 6 and 24 hours. Broths were then incubated for 18-24 hours at 35 degrees C in air, before being transferred to New Granada Medium Modified (NGM) for GBS detection and incubated for a further 18-24 hours at 35 degrees C in air. If the characteristic orange pigmented colonies were observed after this period, the specimen was recorded as + (1-10 colonies) or + + (more than 10 colonies). RESULTS: Overall 92.2% (95/103) of isolates were detected in all tubes and at all times. An additional two isolates were non-hemolytic, non-pigment forming GBS. Of note, 3.9% (4/103) were negative until 2 hours delayed inoculation and 1.9% (2/103) gave inconsistent results, likely due to the low inoculum used. CONCLUSION: Delayed inoculation into selective enrichment broth following a period in transport medium, even with a low inoculum, gave a similar and acceptable GBS detection rate to direct inoculation. Hence, Amies transport medium with charcoal is an appropriate transport medium to use, where it is not practical for clinical specimens to be directly inoculated into selective enrichment broth and as endorsed in the Centers for Diseases Control (CDC) Guidelines, 2002.

Agar↗