Introduction to expert systems peter jackson pdf is There Less Oxygen at High Altitude? International HAPE Database, a database of previous HAPE sufferers worldwide who might consider participating in future research studies. Following these publications, an open comments page was created here.
Data sharing guidelines for AMS research should be agreed. Network Analysis Reveals Distinct Clinical Syndromes Underlying Acute Mountain Sickness. Is poor sleep quality at high altitude separate from acute mountain sickness? Factor structure and internal consistency of the Lake Louise Score Questionnaire. I would be very grateful for your help in getting the ball rolling for a new consensus on the definition and measurement of acute mountain sickness. I am delighted to say that to the organisers of the World Congress meeting in Bolzano this May have generously agreed to my request to hold a discussion session on this topic.
At this meeting, I hope that we will succeed in initiating a discussion of the best way to measure AMS. Ideally we could aim to finalise a new consensus at the next Hypoxia meeting, which I believe will take place in 2015. It would be nice to inaugurate a new consensus in Lake Louise. The definition of AMS has been problematic for decades.
Headache and sleep disturbance occur in different people, at different times, and probably have different aetiologies. Furthermore, the method of measuring acute mountain sickness for research requires consideration. Categorical scoring systems create skewed and non-proportional datasets, and specific language used has a substantial effect on reported symptoms in individuals from different cultures, or of different ages. These problems are not easily solved. In the first instance, I have contacted you because you have published influential work specifically related to the definition of mountain sickness.
I would be very grateful to hear your thoughts on the following questions, as a prelude to a more in-depth preliminary discussion in Bolzano. Any responses at all would be fantastic – this is really just to get things started and to try to work out how to move the process forward. I think the most important initial questions are these:What should be scope and limitations of a new consensus on AMS? How would you like to see a new consensus developed? Should there be a syndrome of AMS, or should we simply measure independent symptoms? Which symptoms do you view as being the cardinal symptoms of AMS?
In what terms should these be described? What sort of scale should be used? LLS 0-3, or visual analogue scale? I will collate the responses and return them to you for further discussion. What should be scope and limitations of a new consensus on AMS?
The AMS scale should be user-friendly and something that a non-clinician e. The traditional assessment scales ESQ-III and LLS should serve as the basis for discussion. These scales should then be modified and revised based on the peer-reviewed literature and new findings that have been published since their inception. In my opinion AMS is a syndrome and should be viewed as such rather than just a series of independent symptoms. I like the LLS criterion of a headache plus at least one additional symptom. Headache is the key symptom of AMS.
Headache is also the one symptom in which I believe a visual analog scale offers some additional information and clarity regarding severity over a categorical scale. There have been some problems with using a visual analog scale VAS to make a global assessment syndrome assessment of AMS see attached paper. However as I mentioned in the previous question I think a VAS is a more discriminating scale than a categorical scale for assessing headache severity and it is commonly used in headache research. As a measurement of the AMS syndrome multi-symptom I like the LLS. Would we want to redefine AMS? My suggestion would be to consider modifying the definition of AMS, and removing or de-emphasising sleep. As part of this process, or under a separate process a definition of, and diagnostic criteria for high altitude sleep disturbance could be developed.
A 3-step process might work . A meeting of individuals interested and experienced in the condition would come up with proposed changes and definitions. This dataset would ideally include altitude visitors from a variety of ethnicities in a variety of conditions, environmentally and geographically. Headache is so much more important than the rest. I’d think that GI symptoms would be the next most important, because if a patient has truly significant nausea and vomiting in the absence of another diagnosis, then I would consider the syndrome more severely. My initial thought was categorical, but with 10 possible answers, so that statistically it would be possible to treat the data as continuous, but still easy to administer in clinical conditions.