What: Matthew Thompson: Identifying children with serious illness in
resource poor settings – how can vital signs be more useful?
When: Tuesday, October 8th at 12 noon
Where: The Allen Center, CSE 203
Join us for the second Change seminar of the fall quarter. This week
Matthew Thompson from the Department of Family Medicine at UW will be
speaking about how vital signs can be used to more effectively identify
serious illness.
*Abstract*
Vital signs are key physiological measures that are used to assess the
overall severity of illness in children, particularly in primary or
community clinical settings. They include heart rate, breathing rate,
temperature, and sometimes blood pressure, oxygen saturations and
capillary refill time. Currently, the WHO’s Integrated Management of
Childhood Illness only routinely uses breathing rate, and even in
established primary care clinics low/middle income settings, vital signs
are measured infrequently.
So why aren’t vital signs used routinely to assess children? As with any
‘signal’, vital signs will only be useful for identifying children with
serious illness if A) They can be measured accurately B) There are
thresholds that define abnormal values, C) The diagnostic value of one
or more abnormal vital signs is known, and D) vital signs provide
diagnostic value over and above other clinical assessments.
Over the past 7 years our Oxford-based group has explored novel ways of
measuring breathing rate in children using the photoplethysmogram signal
from pulse oximeters, developed new evidence-based centile charts of
heart rate and breathing rate in children which are now being adopted
worldwide, quantified the interaction of temperature with heart rate and
with breathing rate, and evaluated the diagnostic accuracy of different
combinations of vital signs for identifying children with serious
illness in various settings.
Vital signs could probably identify the majority of children with
serious illness in primary care settings, but there are major gaps that
prevent vital signs from being adopted routinely to assess unwell
children. In this seminar I will share these research findings with the
aim of exploring possible research collaborations across departments at
UW in developing low cost technological solutions to vital sign
measurement, interpretation/integration, as well as diagnostic accuracy
studies that could inform child assessments in first contact settings in
low/middle income countries
*About the Speaker*
Matthew Thompson has recently moved from the University of Oxford to
take up a new position as Professor and Vice Chair of Research at the
Department of Family Medicine at UW. He has a background as a Family
Physician and trained and worked in the USA, UK and S Africa. He
completed his MPH at UW and a DPhil in diagnostic research at the
University of Oxford.
His research as a clinical epidemiologist in Oxford over the last 10
years has focused on diagnostics, child health and infectious
diseaseshttp://www.phc.ox.ac.uk/team/researchers-n-z/matthew-thompson.
He set up and led the Oxford Centre for Monitoring and Diagnosis, which
evaluates and conducts clinical studies on diagnostic tests and
technologies relevant to primary care, including point of care tests and
electronic devices. His child health research has explored more accurate
ways to identify children with serious illness (e.g. meningitis) in
primary care using clinical features and decision support. He is also
currently PI of an EU-funded study to evaluate a mobile platform based
version of IMCI and vital signs in Malawi, and is working on a Wellcome
Trust study assessing the diagnostic value of vital signs in children in
community clinics in Cape Town.
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