The Physician

BAPIO Annual Conference, Bristol 2024

Indranil Chakravorty — 2024-09-19

Scientific Committee

Developing Role of Artificial Intelligence in Radiology in the UK

Ahsthiya Nagarajan — 2024-09-19

Artificial intelligence (AI) is revolutionising radiological diagnosis in the UK, promising to enhance the accuracy, efficiency, and accessibility of healthcare. The integration of AI into radiology is particularly timely, as the National Health Service (NHS) faces increasing demand for imaging services, coupled with a shortage of radiologists. AI technologies, including deep learning algorithms and machine learning systems, are being developed to assist in interpreting complex medical images such as X-rays, CT scans, and MRIs.

One of the key benefits of AI in radiology is its ability to quickly and accurately detect abnormalities. For instance, AI algorithms can identify early signs of diseases like cancer, strokes, and fractures, often with a precision that rivals or exceeds human expertise. This has the potential to significantly reduce diagnostic errors, expedite treatment plans, and improve patient outcomes. For example, AI tools are already in use in the UK to flag lung nodules on CT scans, assisting radiologists in early cancer detection.

AI also offers efficiency gains. By automating routine tasks, such as identifying normal scans or prioritizing urgent cases, AI can help streamline workflows, reduce waiting times, and alleviate the burden on overworked radiologists. This is critical, as delays in diagnosis can have serious consequences for patient care.

However, the widespread adoption of AI in radiology is not without challenges. Concerns about data privacy, algorithmic transparency, and the potential for over-reliance on AI must be carefully managed. It is crucial to strike a balance where AI complements, rather than replaces, the expertise of radiologists.

Ultimately, AI's role in radiological diagnosis in the UK is poised to grow, offering a future where healthcare is not only faster and more accurate but also more equitable for patients across the country.

Tele-dermatology for Skin Cancer Management

Lubna Gul — 2024-09-18

Teledermatology plays a significant role in the UK National Health Service (NHS) for the management of skin cancers by enhancing early detection, diagnosis, and treatment pathways. It uses digital platforms to allow dermatologists to remotely evaluate skin lesions,
including potential malignancies, based on high-quality images and patient information submitted by general practitioners (GPs) or other healthcare providers.
This approach has proven particularly valuable in reducing wait times for specialist consultations, which is critical for skin cancers where early detection greatly improves outcomes. Through teledermatology, GPs can rapidly refer suspicious lesions to dermatologists, who assess whether further investigation, such as a biopsy or urgent in-person consultation, is required. It helps prioritize high-risk patients for fast-track appointments under the NHS's two-week referral rule for suspected cancers. Teledermatology also facilitates efficient triaging of cases, enabling healthcare systems to manage resources more effectively. Low-risk cases can often be monitored remotely or managed within primary care, reducing unnecessary hospital visits, and easing the burden on specialist services. During the COVID-19 pandemic, the adoption of teledermatology surged, helping maintain continuity of care for skin cancer patients despite restrictions on in-person visits. Overall, teledermatology in the NHS enhances access to specialist care, speeds up the diagnostic process, and improves the management of skin cancers, making it a crucial tool in modern dermatological practice.

This article describes a tele-dermatology service and its outcomes.

Improving Outcomes for under 18-year-olds Requiring Inhalers with no Current Diagnosis of Asthma in Primary Care

Montgomery Gwynne — 2024-09-20

Around 1.1 million children currently receive asthma treatment in the UK. Emergency admissions and deaths from asthma are largely preventable with improved management and monitoring. One of such gaps involves identifying those children who have no diagnosis yet build up a pattern of requiring multiple inhalers yearly. Children may present with wheezy episodes requiring either bronchodilator (reliever) therapy or in some cases inhaled corticosteroids (preventer) therapy. Over the years these children may go undiagnosed and unmonitored, placing them at a higher risk of mortality. Identifying these target at-risk groups will help us identify children who need consideration for an asthma diagnosis and are currently not being managed to standards. This will help as they can be adequately diagnosed, managed, and monitored.

Dietary Acculturation Among International Students in the United Kingdom

Amrit Raj Aravind Shetty — 2024-09-19

There is a significant rise in the proportion of international students pursuing tertiary education in the United Kingdom. This population coming from different countries faces a lot of challenges which contribute to negative health effects and needs further attention. One among these challenges is dietary acculturation. This systematic review aims to explore the factors influencing dietary acculturation and its public health impacts among international students in the UK. Five online databases namely ProQuest Central, Web of Science, Scopus, PsycINFO and Medline were searched, and nine qualitative articles were selected that met the eligibility criteria which were then assessed for quality using Critical Appraisal Skills Programme (CASP) checklist. Methodology involved data extraction and a thematic synthesis, which identified three themes and several sub-themes. The findings of this review indicate that dietary acculturation among international students was affected by tight academic schedules and global fast-food chains. This led to students consuming unhealthy food, contributing to weight gain. However, having social ties and interaction were found to be helpful in dietary acculturation. Higher education institutions can emphasis on nutrition education with focus on substitute foods, alternatives to unhealthy choices, and initiatives to make bicultural food accessible to the students to make the new environment conducive to learning. Public health policies as well as regulations can be made on informed decisions based on an understanding of differences and specific needs of the foreign student population.

Politics of Violence in Healthcare

Indranil Chakravorty — 2024-09-19

Violence against healthcare workers (HCWs) has surged globally, extending beyond conflict zones into areas of relative peace. This editorial examines the epidemic of such violence, which has been exacerbated by recent pandemics. Historical and contemporary instances, such as the 1830s cholera riots, the 2013/14 Ebola outbreak, and recent attacks in Kolkata, highlight how political instability, public mistrust, and socio-economic inequalities fuel aggression against HCWs. A comprehensive analysis reveals that 50-75% of HCWs experience workplace violence, with a significant portion facing sexual abuse. Contributing factors include inadequate security, poor governance, and societal intolerance of HCWs. Possible solutions offer hope, including workplace safety, legal protections, and public awareness of the problem. The editorial calls for a multi-faceted approach involving legislation, better reporting, and global cooperation to address the root causes of violence and improve the safety of HCWs.