Every individual clinical problem solving exercise is a unique valuable contribution to global literature as each and every individual illness trajectory that has been completed is a potential predictive match for an individual illness trajectory that has just begun but days, months or years away from completion. Our case based blended learning ecosystem (CBBLE) aims to gather all these concrete individual experiences and use reflective, qualitative, thematic analysis tools on the data to generate conceptual abstractions toward further active experimentation. It proposes to do so under separate global project teams based on themes centred around problem solving clinical complexity at organizational as well as organ system levels. The list of our current projects linked in detail below is also an invitation to all our department team members (as well as global citizens and system users with an interest in contributing to health research) to join our CBBLE that exists primarily online and yet remains blended to our regular day to day hospital based offline physical workflow. We share below many online links to our past and current work thematically divided into organizational and organ systems complexity along with links to joining user driven healthcare UDHC discussion forums for our PGs and department members along with global citizen researchers to join and start contributing their questions and solutions online along with their regular physical contributions offline in our regular work location. Users are free to start newer project groups and add our key members to guide them online (and offline blended) once they get used to our collective quest for improving health outcomes locally and globally.
Key words : Medical cognition, clinical complexity, case based blended learning ecosystem, user driven healthcare, case based reasoning, conversational learning, qualitative ,non probability, snowball sampling
Some prior references to understand our above keyworded research thrust areas are linked below :
CBBLE : https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6163835/
UDHC : https://pubmed.ncbi.nlm.nih.gov/19018905/
Case based reasoning :
https://www.ncbi.nlm.nih.gov/pmc/articles/pmid/15533257/
Research sampling techniques used:
Non probability sampling :
https://www150.statcan.gc.ca/n1/edu/power-pouvoir/ch13/nonprob/5214898-eng.htm
Snowball sampling :
https://www.statisticshowto.com/probability-and-statistics/statistics-definitions/snowball-sampling/#:~:text=Snowball%20sampling%20is%20where%20research,and%20becomes%20larger%20and%20larger.
Specific projects in progress :
Broad categories :
Organizational systems and Organ systems driven projects
Organ systems driven :
Cardiac :
Clinical organizational complexity driving management of diagnostic and therapeutic uncertainty in pulmonary hypertension and heart failure.
Work done around this project so far :
Work in progress :
Completed :
ASYMPTOMATIC LEFT VENTRICULAR (LV) DIASTOLIC
Project discussion WA group invite link:
Neuro systems project :
Problem Representation
The repercussions of paralysis/weakness are enormous, both personally to the individual and to their family; and have huge economic costs to society. Paralysis takes many forms with multiple disorders causing paralysis, and multiple body systems often affected.
Work in progress :
Motor paralysis outcomes :
Project discussion WA group invite link:
Behaviour analysis project :
Content development of behavioral analysis strategies in an original manner given our contextual settings and patient requirements and not as illustrated in predominantly Western scenarios.
WA group discussion invite link :
Renal organ systems :
1) Factors influencing clinical decision making around therapeutic interventions for critically ill renal failure patients
Work done so far :
2) Clinical organizational complexity driving superinfections in chronic renal failure. Work done around this project so far :
2019-20 CHRONIC KIDNEY DISEASE PATIENTS:
MARKER FOR EARLY DETECTION OF CHRONIC KIDNEY DISEASE:
3) Predictors of outcomes in patients of Chronic kidney disease
Project discussion WA group invite link:
Gastro organ systems :
Outcomes in Ascites :
Work done so far :
SERUM ALBUMIN ASCITIC GRADIENT IN THE ETIOLOGICAL DIAGNOSIS OF ASCITIS:
MORTALITY AND INTERMEDIATE MARKERS OF SEVERITY IN ACUTE PANCREATITIS”
Project discussion WA group invite link:
Multiple organ systems projects :
Communicable (Infectious) diseases:
Tuberculosis diagnostic and therapeutic uncertainty :
Problem statement :
Private and government centers in India indulge in a lot of empirical antitubercular therapy due to clinical complexity (diagnostic and therapeutic uncertainty) surrounding it's management and how we may be able to reduce this overdiagnosis and overtreatment of tuberculosis at the same time taking care not to undertreat using hitherto unknown tools and it also builds on the theme of how we in the past tackled clinical complexity surrounding poorly differentiated fever using simple tools such as fever chart patterns and checklists (another updated publication on our fever project is also long overdue given the four year case report data on fever we have).
More about the fever project here :
Past publications (patient centered) around tuberculosis clinical complexity :
Non communicable diseases NCDs:
Life style disorders : Visceral Fat, Diabetes , hypertension, vasculopathy
Past project formulations :
Past published work (patient centered) :
Here are two sample case report links of our current patients where the regular diet and activity is being followed :
Patient Journey Record Systems (PaJR): The Development of a Conceptual Framework for a Patient Journey System. In R. Biswas, & C. Martin (Eds.), User-Driven Healthcare and Narrative Medicine: Utilizing Collaborative Social Networks and Technologies (pp. 75-92). Hershey, PA: Medical Information Science Reference. doi:10.4018/978-1-60960-097-6.ch006http://www.igi-global.com/chapter/patient-journey-record-systems-pajr/49246
Whatsapp Group for
diet and exercise lifestyle medicine project :
Alcohol use disorders and diet exercise life style medicine intervention project :
Resolving diagnostic and therapeutic uncertainty in patients with hyponatremia
Organizational systems driven :
Theme 1: clinical complexity, diagnostic and therapeutic uncertainty, medical cognition)
1) Resolving organizational clinical complexity through quality improvement tools in a case based blended learning ecosystem CBBLE
Project discussion WA group invite link:
Work done and conversational learning around this project so far
(2012). Understanding Clinical Complexity through conversational learning in medical social networks: Implementing User Driven Health care. In J.P. Sturmberg and Carmel.M. Martin (Ed.), Handbook on Complexity in Health (pp. ). New York, NY. Springer.
Organizational systems driven :
Theme 2: scholarship of integration, medical education and research, Integrative medicine, clinical complexity, diagnostic and therapeutic uncertainty, medical cognition)
Project details:
3) Medical education project done by our senior resident post MD and the "work in progress" is linked below :
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