GI Liver and Emergencies vs CLDF ACLF-MELD calculator Uso & Estadísticas

The field of medicine revolves around putting existing knowledge into action in the best interest of the patient. The field of knowledge translation pertains to bridging barriers in order to bring the existing knowledge into action.1 Large amount of time and resources are spent on creating evidence-based guidelines. They are usually published in textbooks, society guidelines and manuals. They take time for this knowledge to percolate to each and every treating physician and thus do not end up benefitting each and every patient for whom it was intended. 1-3 This vast gap is due to the practical difficulties for the treating doctor in quickly and effectively accessing these resources. The guidelines also keep changing with time and it is impractical for each physician to be abreast with all the latest guidelines.  Various emergency departments have thus created customised protocols for managing emergency situation in their setup. These are usually in a printed format and available as a manual. However, they are difficult to update, bulky to access and may be not easily traceable. There is thus a felt need to provide evidence based information in an easily accessible and updatable format to the treating physician at the bedside of the patient. In India, most of the trainee physicians possess smart phones. A smart app which can provide the necessary information for managing common GI emergencies on their finger tips can enhance patient care and as well provide training.4,5 We, at PGIMER Chandigarh, recently designed a GI liver mobile app to provide a decision support tool for managing 15 common GI liver emergencies. It has been made in a user friendly, intuitive, easily navigatable colour coded actionable format. The assessment and management of each emergency is provided under the sections of diagnosis, investigations, severity assessment and management. The contents of this app were deliberated upon by the departmental faculty and were subsequently vetted by national experts.  The utility of it in clinical scenarios was validated by a study conducted among resident doctors (n=42) in PGIMER, Chandigarh found that it enhanced their mean performance scores from 57 to 71 in simulated conditions(p less than 0.001). This app was launched at the midterm ISG meeting in Delhi and is now freely downloadable from the website (www.pgimer.edu.in). The feedback has been overwhelmingly positive and over 1400 physicians have already downloaded it. We feel that apps like these are likely to reduce time to decision making, reduce duration of stay in the emergency area and improve overall patient outcomes. However, further studies to assess its efficacy in real life scenario needs to be conducted. DISCLAIMER: This app is for the use of Doctors and medical practitioners only. The authors and app developers are not responsible for errors or omissions or for any consequences from application of the information contained in this mobile application and make no warranty, expressed or implied with respect to the currency, completeness or accuracy of the contents of the mobile application. In no event shall the authors or app developers be liable to any party for any damages, included but not limited to direct, indirect, special, incidental, or consequential damages. The application provided hereunder in on an “as is” basis and the authors and app developers have no obligation to provide maintenance, support, updates, enhancements or modifications. The application of the information in any particular situation remains the professional responsibility of the doctor/ medical practitioner.
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The ACLF Calculated score is a scientifically validated and useful tool in managing patients with acute on chronic liver failure (ACLF). The following is one of many peer reviewed scientific papers discussing the validity and utility of the ACLF calculation: Jalan, R. et al. Development and validation of a prognostic score to predict mortality in patients with acute-on-chronic liver failure. J. Hepatol. 61, 1038–1047 (2014). In addition, there are a large number of medical calculators for determining ACLF online, many of which are endorsed by major medical bodies. Here is one example: https://www.efclif.com/scientific-activity/score-calculators/clif-c-aclf The MELD Calculated score is a validated and often used medical calculation for managing patients with end stage liver disease. The following is one of many peer reviewed scientific papers demonstrating the utility and medical validation of the MELD calculation: Kamath, P. S. & Kim, W. R. The model for end-stage liver disease (MELD). Hepatology (Baltimore, MD) 45, 797–805 (2007). In addition, there are many online calculators for MELD in use, major institutions like the Mayo Clinic and other well-known and respected medical organizations provide the MELD calculators for their clinicians to utilize, like the example below: https://optn.transplant.hrsa.gov/data/allocation-calculators/meld-calculator/ The combined ACLF/MELD calculator is a way for providers to simply put in the values for both calculators at once to get the results of both on one screen thereby simplifying the input and work for the provider. Dr. David Bernstein, a member of the Chronic Liver Disease Foundation (chronicliverdisease.org), a medical nonprofit made up leading liver specialists in the United States, has reviewed this calculator for it’s accuracy and utility and recommends its use in helping to manage patients with these illnesses.
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GI Liver and Emergencies VS.
CLDF ACLF-MELD calculator

17iciembre d, 2024