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 diseases http://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.