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Details

  • Name

    Pedro Pereira Rodrigues
  • Cluster

    Computer Science
  • Role

    External Research Collaborator
  • Since

    04th January 2010
Publications

2020

Identification of hospitalized patients with community-acquired infection in whom treatment guidelines do not apply: a validated model

Authors
Cardoso, T; Rodrigues, PP; Nunes, C; Almeida, M; Cancela, J; Rosa, F; Rocha Pereira, N; Ferreira, IS; Seabra Pereira, F; Vaz, P; Carneiro, L; Andrade, C; Davis, J; Marcal, A; Friedman, ND;

Publication
JOURNAL OF ANTIMICROBIAL CHEMOTHERAPY

Abstract
Objectives: To develop and validate a clinical model to identify patients admitted to hospital with community-acquired infection (CAI) caused by pathogens resistant to antimicrobials recommended in current CAI treatment guidelines. Methods: International prospective cohort study of consecutive patients admitted with bacterial infection. Logistic regression was used to associate risk factors with infection by a resistant organism. The final model was validated in an independent cohort. Results: There were 527 patients in the derivation and 89 in the validation cohort. Independent risk factors identified were: atherosclerosis with functional impairment (Karnofsky index <70) [adjusted OR (aOR) (95% CI) = 2.19 (1.41-3.40)]; previous invasive procedures [adjusted OR (95% CI) = 1.98 (1.28-3.05)]; previous colonization with an MDR organism (MDRO) [aOR (95% CI) = 2.67 (1.48-4.81)]; and previous antimicrobial therapy [aOR (95% CI) = 2.81 (1.81-4.38)]. The area under the receiver operating characteristics (AU-ROC) curve (95% CI) for the final model was 0.75 (0.70-0.79). For a predicted probability >= 22% the sensitivity of the model was 82%, with a negative predictive value of 85%. In the validation cohort the sensitivity of the model was 96%. Using this model, unnecessary broad-spectrum therapy would be recommended in 30% of cases whereas undertreatment would occur in only 6% of cases. Conclusions: For patients hospitalized with CAI and none of the following risk factors: atherosclerosis with functional impairment; previous invasive procedures; antimicrobial therapy; or MDRO colonization, CAI guidelines can safely be applied. Whereas, for those with some of these risk factors, particularly if more than one, alternative antimicrobial regimens should be considered.

2020

Simulation of the effects of COVID-19 testing rates on hospitalizations

Authors
Sousa Pinto, B; Fonseca, JA; Oliveira, B; Cruz Correia, R; Rodrigues, PP; Costa Pereira, A; Rocha Goncalves, FN;

Publication
BULLETIN OF THE WORLD HEALTH ORGANIZATION

Abstract

2020

Informatics as support for changes in health policy: A case in obstetrics

Authors
Gelatti, GJ; Rodrigues, PP; Cruz Correia, RJ;

Publication
HEALTHINF 2020 - 13th International Conference on Health Informatics, Proceedings; Part of 13th International Joint Conference on Biomedical Engineering Systems and Technologies, BIOSTEC 2020

Abstract
Introduction: In 2015 the Directorate-General for Health of Portugal published new standards (DGS 001/2015) for the registration of cesarean section indicators. The existing scenario was the lack of data, influencing the quality of indicators and analyses on them. The use of a single computer tool was encouraged to register and compare indicators between hospitals with special attention to the Robson Classification as it employs basic information of pregnancy to classify all deliveries in 10 groups. The selected tool was Obscare software. Aim: Describe the scenario on data quality by analyzing the completeness of obstetric records from 2016 to 2018 of the variables used in Robson's classification collected by the Obscare tool. Methods: The completeness is evaluated using a number of missing values. The lower the completeness, the higher the number of missing values. Also, we perform the imputation of data based on basic concepts and analyzed the participation of this data in the indication of the type of delivery to be performed according to classification suggested by DGS 001/2015. Results: From 2016 to 2018, 5922 number of pregnancies resulted in 5922 of Robson Classifications. The variables with lower completeness were related to previous cesarean section (77%) and previous pregnancies (43%). After imputation, it fell to 3.9% and 0.56%, respectively causing 4.6% of discarded data from the total. Discussion: There is a significant amount of missing data in basic variables used to study the classification of delivery type. We believe that encouraging data completion with the possibility of comparing data between hospitals should be a priority in the health area.

2020

Determining the prevalence of palliative needs and exploring screening accuracy of depression and anxiety items of the integrated palliative care outcome scale - a multi-centre study

Authors
Antunes, B; Rodrigues, PP; Higginson, IJ; Ferreira, PL;

Publication
BMC PALLIATIVE CARE

Abstract
Background patients with palliative needs often experience high symptom burden which causes suffering to themselves and their families. Depression and psychological distress should not be considered a "normal event" in advanced disease patients and should be screened, diagnosed, acted on and followed-up. Psychological distress has been associated with greater physical symptom severity, suffering, and mortality in cancer patients. A holistic, but short measure should be used for physical and non-physical needs assessment. The Integrated Palliative care Outcome Scale is one such measure. This work aims to determine palliative needs of patients and explore screening accuracy of two items pertaining to psychological needs. Methods multi-centred observational study using convenience sampling. Data were collected in 9 Portuguese centres. Inclusion criteria: >= 18 years, mentally fit to give consent, diagnosed with an incurable, potentially life-threatening illness. Exclusion criteria: patient in distress ("unable to converse for a period of time"), cognitively impaired. Descriptive statistics used for demographics. Receiving Operator Characteristics curves and Area Under the Curve for anxiety and depression discriminant properties against the Hospital Anxiety and Depression Scale. Results 1703 individuals were screened between July 1st, 2015 and February 2016. A total of 135 (7.9%) were included. Main reason for exclusion was being healthy (75.2%). The primary care centre screened most individuals, as they have the highest rates of daily patients and the majority are healthy. Mean age is 66.8 years (SD 12.7), 58 (43%) are female. Most patients had a cancer diagnosis 109 (80.7%). Items scoring highest (=4) were: family or friends anxious or worried (36.3%); feeling anxious or worried about illness (13.3%); feeling depressed (9.6%). Using a cut-off score of 2/3, Area Under the Curve for depression and anxiety items were above 70%. Conclusions main palliative needs were psychological, family related and spiritual. This suggests that clinical teams may better manage physical issues and there is room for improvement regarding non-physical needs. Using the Integrated Palliative care Outcome Scale systematically could aid clinical teams screening patients for distressing needs and track their progress in assisting patients and families with those issues.

2019

Learner's perception, knowledge and behaviour assessment within a breast imaging E-Learning course for radiographers

Authors
Moreira, IC; Ramos, I; Ventura, SR; Rodrigues, PP;

Publication
EUROPEAN JOURNAL OF RADIOLOGY

Abstract
Purpose: E-learning has been revealed as an a useful tool among continuing education within health professionals, namely for radiographers or radiologic technologists. Therefore like traditional learning, this teaching approach needs continuous evaluation in order to validate its effectiveness and impact. Kirkpatrick's model has been widely used for this purpose by health information management instructors. Our aim was to assess an E-learning Course on Breast Imaging for radiographers based on the first three levels of Kirkpatrick's framework: reaction, learning and behaviour. Methods and materials: An E-learning course was developed for radiographers in order to provide an easy-to-understand, succinct and current overview in breast imaging, namely mammography technique and image interpretation. The program structure were built based on the guidelines proposed by the European Society of Breast Cancer Specialists (EUSOMA). Learner's satisfaction was assessed through a questionnaire and Knowledge gain was assessed using pre- and post-testing. After 6 months of complying the course, the learners were contacted through a questionnaire in order to give feedback on whether their behaviour changed in workplace. Results: Two editions of the breast imaging course were performed by 64 learners. In general, 97% of the learners stated that the program content was very good and excellent, all learners considered the content was delivered in a very good or excellent way. High percentages of learners stated to be satisfied with the distribution of the content among each module (94%) and 86% of learners stated that your level of dedication was high or very high. Concerning improvement of knowledge, we found an evolution of 4 percentual points between pre and post-tests (p = 0,001). The learners have identified two main changes on their practice, the first one related with patient care, improving communications and positioning skills and the second one related with image interpretation, improving the image processing and analyses. Conclusion: These global results show that e-learning can provide statistically relevant knowledge gains in Radiographers. This course is an important contribution to the improvement of mammography education, impacting on the development of students' and radiographers' skills.