Abstract:
:Surgeons are increasingly using ultrasonography (US) in their clinical management of patients. However, US is a very user-dependent imaging modality and proper skills of the US operator are needed to ensure quality in patient care. This thesis explores the validity evidence for assessment of competence in abdominal and head & neck ultrasonography using the Objective Structured Assessment of Ultrasound Skills (OSAUS) scale. With the use of Messick's unitary framework of validity, five sources of validity evidence were explored: test content, response processes, inter-nal structure, relations to other variables, and consequences. Research paper I examined validity evidence for the use of the OSAUS scale to assess physicians' abdominal point-of-care US competence in an experimental setting using patient cases with and without pathological conditions. The RESULTS provided validity evidence of the internal structure of the OSAUS scale and a deci-sion study predicted that four cases and two raters or five cases and one rater could ensure sufficient reliability in future test setups. The relation to other variables was supported by a signifi-cant difference in scores between US experience levels, and by a strong correlation between the OSAUS score and diagnostic accuracy. Research paper II explored the transfer of learning from formal point-of-care US training to performance on patients in a randomized controlled study. The RESULTS supported validity evi-dence regarding OSAUS scores' relation to other variables by demonstrating a significant discrimination in the progress of training-a more refined validity evidence than the relation to difference experience levels. The RESULTS showed that physicians could transfer the skills learned on an ultrasonography course to improved US performance and diagnostic accuracy on patients. However, the RESULTS also indicated that following an initial course, additional training is needed for physicians to achieve competence in US. Research paper III evaluated validity evidence supporting an OSAUS score used to establish pass/fail standards for head & neck US skills. Good reliability between raters from different specialties to assess head & neck competence further supported the internal structure of OSAUS scale. A strong correla-tion to the diagnostic accuracy supported the relation to other variables and the consequences of the assessment were explored by a receiver operator characteristic curve for different pass/fail standards of head & neck US skills. In summary this PhD thesis established sources of validity evi-dence supporting the interpretation of the OSAUS scale to evalu-ate surgeon-performed US skills of the abdominal and head & neck diseases. We therefore recommend the OSAUS scale for formative in-training assessment and high-stakes summative decisions as certification for independent practice in surgeon-performed US. Further, we find formal "hands on" courses an essential part of initial US training with good transfer of learning to improved diagnostic accuracy. This thesis can therefore be used to support the move towards competency-based training in abdominal and head & neck US.
journal_name
Dan Med Jjournal_title
Danish medical journalauthors
Todsen Tsubject
Has Abstractpub_date
2017-11-01 00:00:00issue
11issn
2245-1919pii
B5421journal_volume
64pub_type
杂志文章abstract::Critically ill acute high-risk abdominal surgery patients represent a major challenge to health care providers, with the typical patient being elderly and frail, and with severe and multiple comorbidities. The mortality rate in this population is high, and the postoperative course is characterized by complications, pr...
journal_title:Danish medical journal
pub_type: 杂志文章,评审
doi:
更新日期:2018-02-01 00:00:00
abstract:INTRODUCTION:Due to the coronavirus disease 2019 (COVID-19) exposure in Denmark, first-line referral centres were established to handle all patients suspected of COVID-19 or other upper respiratory tract infection. Here we report the first experiences from a first-line referral centre from Amager-Hvidovre Hospital, sit...
journal_title:Danish medical journal
pub_type: 杂志文章
doi:
更新日期:2020-08-07 00:00:00
abstract:INTRODUCTION:The Danish Adult Diabetes Database (DADD) annually reports a quality indicator for lipid-lowering treatment of type 2 diabetes mellitus (T2DM) patients. This retrospective cohort study aims to A) investigate the reasons for inadequate or lacking lipid-lowering treatment and to B) assess the validity of the...
journal_title:Danish medical journal
pub_type: 杂志文章
doi:
更新日期:2018-09-01 00:00:00
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journal_title:Danish medical journal
pub_type: 杂志文章
doi:
更新日期:2017-05-01 00:00:00
abstract:INTRODUCTION:Adjuvant treatment of early-stage breast cancer has been associated with bone loss in randomised trials, but evidence from unselected populations is needed. In a single-center study, we assessed the annual percentage change in bone mineral density (∆BMDt) and risk of osteoporosis from two to five years aft...
journal_title:Danish medical journal
pub_type: 杂志文章
doi:
更新日期:2020-10-20 00:00:00
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journal_title:Danish medical journal
pub_type: 杂志文章
doi:
更新日期:2012-06-01 00:00:00
abstract:INTRODUCTION:Patient blood management strategies for total hip and knee arthroplasty are controversial. They range from pre-operative haemoglobin optimisation to intra- and post-operative interventions. The aim of this study was to assess the various treatment modalities with respect to blood loss, haemoglobin levels a...
journal_title:Danish medical journal
pub_type: 杂志文章,评审
doi:
更新日期:2015-12-01 00:00:00
abstract:BACKGROUND:Active surveillance - an initial observational strategy - offers a tailored management of patients with localised prostate cancer. The aim of the strategy is to appoint patients with potentially lethal prostate cancer to curatively intended treatment, while patients with slowly evolving tumours are spared fr...
journal_title:Danish medical journal
pub_type: 杂志文章
doi:
更新日期:2015-02-01 00:00:00
abstract:INTRODUCTION:Vitamin D plays an important role in a broad range of organ functions, including the cardiovascular system. Only one study has tested the association between vitamin D deficiency and arrhythmia and it found no association. The aim of the present study was to evaluate the association between vitamin D defic...
journal_title:Danish medical journal
pub_type: 杂志文章
doi:
更新日期:2012-09-01 00:00:00
abstract:INTRODUCTION:Patients with localised and locally advanced renal cancer experience about 20% recurrence during a five-year follow-up period. The aim of the present study was to report recurrence rates and survival in a Danish population with renal cancer. METHODS:Data on patients diagnosed with renal cell carcinoma (RC...
journal_title:Danish medical journal
pub_type: 杂志文章
doi:
更新日期:2016-04-01 00:00:00
abstract:INTRODUCTION:Knowledge of trauma patients is often based on US studies. However, these may not be representative of the Scandinavian population. Knowing which trauma patients are at risk of dying might help us target and optimise their treatment. The purpose of this study was to examine the epidemiological characterist...
journal_title:Danish medical journal
pub_type: 杂志文章
doi:
更新日期:2014-10-01 00:00:00
abstract::Ischemia-reperfusion injuries occur when the blood supply to an organ or tissue is temporarily cut-off and then restored. Even though the restoration of blood flow is absolutely essential in preventing tissue death, the reperfusion of oxygenated blood to the oxygen-deprived areas may in itself augment the tissue damag...
journal_title:Danish medical journal
pub_type: 杂志文章,评审
doi:
更新日期:2015-04-01 00:00:00
abstract:INTRODUCTION:When patients are transferred from intensive care units (ICUs) to general wards with a tracheostomy in situ, there is a risk of suboptimal care and increased morbidity. The aim of this study was to elucidate the management of patients with a tracheostomy in situ at discharge from the ICU to the ward. MATE...
journal_title:Danish medical journal
pub_type: 杂志文章
doi:
更新日期:2012-08-01 00:00:00
abstract:INTRODUCTION:There is no consensus among hip surgeons in Denmark on how to follow up patients after total hip arthroplasty (THA). Agreement on the need for radiographic examinations is also lacking. The purpose of this study was to evaluate if routine outpatient post-operative radiographs, obtained three and 12 months ...
journal_title:Danish medical journal
pub_type: 杂志文章
doi:
更新日期:2013-04-01 00:00:00
abstract::Bariatric surgery (e.g. Roux-en-Y gastric bypass (RYGB)) has proven the most effective way of achieving sustainable weight losses and remission of type 2 diabetes (T2D). Studies indicate that the effectiveness of RYGB is mediated by an altered gastrointestinal tract anatomy, which in particular favours release of the ...
journal_title:Danish medical journal
pub_type: 杂志文章,评审
doi:
更新日期:2016-11-01 00:00:00
abstract:INTRODUCTION:Danish healthcare seeks to improve cancer survival through improved diagnostics, rapid treatment and increased focus on cancer prevention and early help-seeking. In neuro-oncology, this has resulted in the Integrated Brain Cancer Pathway (IBCP). The paper explores how the pathway works in the initial phase...
journal_title:Danish medical journal
pub_type: 杂志文章
doi:
更新日期:2012-05-01 00:00:00
abstract:INTRODUCTION:Since the introduction of the quadrivalent human papillomavirus vaccine, young girls and women have reported a broad range of symptoms. These have been described as possible adverse effects of the vaccine. In this study, we describe demographic characteristics, symptomatology, clinical and laboratory test ...
journal_title:Danish medical journal
pub_type: 杂志文章
doi:
更新日期:2017-07-01 00:00:00
abstract:INTRODUCTION:The aim of the study is to identify how disease management programmes for patients with a chronic disease work. This issue is explored from the patients' perspective. Specifically, we study how transition and coordination are related to the patient's perception of quality of care, with a particular focus o...
journal_title:Danish medical journal
pub_type: 杂志文章
doi:
更新日期:2016-03-01 00:00:00
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journal_title:Danish medical journal
pub_type: 杂志文章,随机对照试验
doi:
更新日期:2017-05-01 00:00:00
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journal_title:Danish medical journal
pub_type: 杂志文章,评审
doi:
更新日期:2012-07-01 00:00:00
abstract::The epidemiology and prognosis of ''fainting'' or syncope has puzzled physicians over the years. Is fainting dangerous? This is a question often asked by the patient--and the answer is ''it depends on a lot of things''. The diverse pathophysiology of syncope and the underlying comorbidites of the patients play an esse...
journal_title:Danish medical journal
pub_type: 杂志文章,评审
doi:
更新日期:2013-09-01 00:00:00
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journal_title:Danish medical journal
pub_type: 临床试验,杂志文章
doi:
更新日期:2012-01-01 00:00:00
abstract:INTRODUCTION:Patients with diabetes suffering from hypoglycaemia may be treated by a Mobile Emergency Care Unit (MECU) and are often released at the scene following treatment. Some of these patients experience secondary hypoglycaemia and require renewed treatment or admission to hospital. The present study was initiate...
journal_title:Danish medical journal
pub_type: 杂志文章
doi:
更新日期:2015-04-01 00:00:00
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journal_title:Danish medical journal
pub_type: 杂志文章
doi:
更新日期:2012-03-01 00:00:00
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journal_title:Danish medical journal
pub_type: 杂志文章
doi:
更新日期:2014-11-01 00:00:00
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journal_title:Danish medical journal
pub_type: 杂志文章
doi:
更新日期:2017-12-01 00:00:00
abstract::Heart failure is a complex clinical syndrome and one of the leading causes of morbidity and mortality with a prevalence of 1%-2% of the adult population. The prognosis is poor with a 5-year mortality rate of 50%, which partly can be attributed to the presence of concomitant comorbidity, including neurological and psyc...
journal_title:Danish medical journal
pub_type: 杂志文章,评审
doi:
更新日期:2018-04-01 00:00:00
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journal_title:Danish medical journal
pub_type: 杂志文章
doi:
更新日期:2015-01-01 00:00:00
abstract:INTRODUCTION:Reliable dietary information is crucial for measuring the habitual diet of healthy participants and patients with dyslipidaemia and/or coronary heart disease (CHD). Even so, methods are often complicated and time-consuming for everyone involved. We aimed to validate the new food frequency questionnaire (FF...
journal_title:Danish medical journal
pub_type: 杂志文章
doi:
更新日期:2018-11-01 00:00:00
abstract:INTRODUCTION:Despite rehabilitation programmes offered to all patients with newly diagnosed type 2 diabetes in Denmark, a number of patients either never accomplish good diabetes regulation or the regulation deteriorates with time. Therefore, new approaches are needed. The aim of the present study is to examine whether...
journal_title:Danish medical journal
pub_type: 杂志文章,随机对照试验
doi:
更新日期:2013-12-01 00:00:00