Prevalence and Associations of General Practice Registrars’ Management of Atopic Dermatitis: A Cross-Sectional Analysis from the Registrar Clinical Encounters in Training Study

Willems, Anneliese; Tapley, Amanda; Fielding, Alison; Tng, Er Tsing Vivian; Holliday, Elizabeth G.; Driel, Mieke van; Ball, Jean; Davey, Andrew; Patsan, Irena; FitzGerald, Kristen; Spike, Neil; Magin, Parker

doi:10.5826/dpc.1104a128

Cited by 3 publications

(2 citation statements)

References 44 publications

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“…Exploratory analyses allow us to establish associations of a wide range of registrar clinical exposures-for example, patient demographics (older patients [40], Aboriginal and Torres Strait Islander patients) [42] and problems/ diagnoses (for example, atopic dermatitis [43], post-natal care [44], vertigo [45]); and registrar actions (prescribing [46], deprescribing [47], delayed prescribing [48], test-ordering [49], referral [50], and preventive activities [51]). We can also examine the associations of structural aspects of the training experience.…”

Section: Exploratory Analysesmentioning

confidence: 99%

The Registrar Clinical Encounters in Training (ReCEnT) cohort study: updated protocol

et al. 2022

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Background During vocational general practice training, the content of each trainee’s (in Australia, registrars’) in-consultation clinical experience is expected to entail a breadth of conditions that exemplify general practice, enabling registrars to gain competency in managing common clinical conditions and common clinical scenarios. Prior to the Registrar Clinical Encounters in Training (ReCEnT) project there was little research into the content of registrars’ consultations despite its importance to quality of training. ReCEnT aims to document the consultation-based clinical and educational experiences of individual Australian registrars. Methods ReCEnT is an inception cohort study. It is comprised of closely interrelated research and educational components. Registrars are recruited by participating general practice regional training organisations. They provide demographic information about themselves, their skills, and their previous training. In each of three 6-month long general practice training terms they provide data about the practice where they work and collect data from 60 consecutive patient encounters using an online portal. Analysis of data uses standard techniques including linear and logistic regression modelling. The ReCEnT project has approval from the University of Newcastle Human Research Ethics Committee, Reference H-2009–0323. Discussion Strengths of the study are the granular detail of clinical practice relating to patient demographics, presenting problems/diagnoses, medication decisions, investigations requested, referrals made, procedures undertaken, follow-up arranged, learning goals generated, and in-consultation help sought; the linking of the above variables to the presenting problems/diagnoses to which they pertain; and a very high response rate. The study is limited by not having information regarding severity of illness, medical history of the patient, full medication regimens, or patient compliance to clinical decisions made at the consultation. Data is analysed using standard techniques to answer research questions that can be categorised as: mapping analyses of clinical exposure; exploratory analyses of associations of clinical exposure; mapping and exploratory analyses of educational actions; mapping and exploratory analyses of other outcomes; longitudinal ‘within-registrar’ analyses; longitudinal ‘within-program’ analyses; testing efficacy of educational interventions; and analyses of ReCEnT data together with data from other sources. The study enables identification of training needs and translation of subsequent evidence-based educational innovations into specialist training of general practitioners.

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Section: Exploratory Analysesmentioning

confidence: 99%

The Registrar Clinical Encounters in Training (ReCEnT) cohort study: updated protocol

et al. 2022

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“…As a common, chronic inflammatory dermatosis, atopic dermatitis (AD) is characterized by relapsing eczematous and pruritic skin lesions 1 . The prevalence rate of AD ranged from 1 to 20% worldwide 2 , and the incidence of this condition has been gradually increasing.…”

Section: Introductionmentioning

confidence: 99%

Identification of novel candidate genes and predicted miRNAs in atopic dermatitis patients by bioinformatic methods

Chen

Xin

Wang

et al. 2022

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Atopic dermatitis (AD) is a common, chronic inflammatory dermatosis with relapsing eruptions. Our study used bioinformatics to find novel candidate differentially expressed genes (DEGs) and predicted miRNAs between AD patients and healthy controls. The Mesh term “atopic dermatitis” was retrieved to obtain DEGs in GEO datasets. DEGs between AD patients and healthy controls were analyzed using GEO2R. Overlapping DEGs between different datasets were obtained with use of Draw Venn software. GO and KEGG enrichment analyses were conducted by the use of DAVID. STRING and miRWalk were used to individually analyze PPI networks, interactions of candidate genes and predicted miRNAs. A total of 571 skin samples, as retrieved from 9 databases were assessed. There were 225 overlapping DEGs between lesioned skin samples of AD patients and that of healthy controls. Nineteen nodes and 160 edges were found in the largest PPI cluster, consisting of 17 up-regulated and 2 down-regulated nodes. Two KEGG pathways were identified, including the cell cycle (CCNB1, CHEK1, BUB1B, MCM5) and p53 (CCNB1, CHEK1, GTSE1) pathways. There were 56 nodes and 100 edges obtained in the miRNA-target gene network, with has-miR-17-5p targeted to 4 genes and has-miR-106b-5p targeted to 3 genes. While these findings will require further verification as achieved with experiments involving in vivo and in vitro modles, these results provided some initial insights into dysfunctional inflammatory and immune responses associated with AD. Such information offers the potential to develop novel therapeutic targets for use in preventing and treating AD.

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Burden of Disease and Unmet Needs in the Diagnosis and Management of Atopic Dermatitis in Diverse Skin Types in Australia

Courtney

Lopez

Lowe

et al. 2023

JCM

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Atopic dermatitis (AD) is a common, chronic, inflammatory skin disease affecting Australians of all ages, races, ethnicities, and social classes. Significant physical, psychosocial, and financial burdens to both individuals and Australian communities have been demonstrated. This narrative review highlights knowledge gaps for AD in Australian skin of colour. We searched PubMed, Wiley Online Library, and Cochrane Library databases for review articles, systematic reviews, and cross-sectional and observational studies relating to AD in Australia for skin of colour and for different ethnicities. Statistical data from the Australian Institute of Health and Welfare and the Australian Bureau of Statistics was collected. In recent years, there has been substantially increased awareness of and research into skin infections, such as scabies and impetigo, among various Australian subpopulations. Many such infections disproportionately affect First Nations Peoples. However, data for AD itself in these groups are limited. There is also little written regarding AD in recent, racially diverse immigrants with skin of colour. Areas for future research include AD epidemiology and AD phenotypes for First Nations Peoples and AD trajectories for non-Caucasian immigrants. We also note the evident disparity in both the level of understanding and the management standards of AD between urban and remote communities in Australia. This discrepancy relates to a relative lack of healthcare resources in marginalised communities. First Nations Peoples in particular experience socioeconomic disadvantage, have worse health outcomes, and experience healthcare inequality in Australia. Barriers to effective AD management must be identified and responsibly addressed for socioeconomically disadvantaged and remote-living communities to achieve healthcare equity.

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Prevalence and Associations of General Practice Registrars’ Management of Atopic Dermatitis: A Cross-Sectional Analysis from the Registrar Clinical Encounters in Training Study

Cited by 3 publications

References 44 publications

The Registrar Clinical Encounters in Training (ReCEnT) cohort study: updated protocol

The Registrar Clinical Encounters in Training (ReCEnT) cohort study: updated protocol

Identification of novel candidate genes and predicted miRNAs in atopic dermatitis patients by bioinformatic methods

Burden of Disease and Unmet Needs in the Diagnosis and Management of Atopic Dermatitis in Diverse Skin Types in Australia

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