Department of Cardiology, The University of Texas MD Anderson Cancer Center, 1400 Pressler Street, Unit 1451, Houston, TX77030, USA.
Center for Artificial Intelligence & Health Equity, Global System Analytics & Structures, New Orleans, LA, USA.
Public Health Nutr. 2022 Feb;25(2):281-289. doi: 10.1017/S1368980021002809. Epub 2021 Jun 28.
We sought to produce the first meta-analysis (of medical trainee competency improvement in nutrition counseling) informing the first cohort study of patient diet improvement through medical trainees and providers counseling patients on nutrition.
(Part A) A systematic review and meta-analysis informing (Part B) the intervention analysed in the world's largest prospective multi-centre cohort study on hands-on cooking and nutrition education for medical trainees, providers and patients.
(A) Medical educational institutions. (B) Teaching kitchens.
(A) Medical trainees. (B) Trainees, providers and patients.
(A) Of the 212 citations identified (n 1698 trainees), eleven studies met inclusion criteria. The overall effect size was 9·80 (95 % CI (7·15, 12·45) and 95 % CI (6·87, 13·85); P < 0·001), comparable with the machine learning (ML)-augmented results. The number needed to treat for the top performing high-quality study was 12. (B) The hands-on cooking and nutrition education curriculum from the top performing study were applied for medical trainees and providers who subsequently taught patients in the same curriculum (n 5847). The intervention compared with standard medical care and education alone significantly increased the odds of superior diets (high/medium v. low Mediterranean diet adherence) for residents/fellows most (OR 10·79, 95 % CI (4·94, 23·58); P < 0·001) followed by students (OR 9·62, 95 % CI (5·92, 15·63); P < 0·001), providers (OR 5·19, 95 % CI (3·23, 8·32), P < 0·001) and patients (OR 2·48, 95 % CI (1·38, 4·45); P = 0·002), results consistent with those from ML.
The current study suggests that medical trainees and providers can improve patients' diets with nutrition counseling in a manner that is clinically and cost effective and may simultaneously advance societal equity.
我们旨在进行首次荟萃分析（评估医学受训者在营养咨询方面的能力提升），为首个通过医学受训者和医务人员为患者提供营养咨询来改善患者饮食的队列研究提供信息。
（A）系统评价和荟萃分析为（B）世界上最大的前瞻性多中心队列研究提供信息，该研究涉及医学受训者、医务人员和患者进行实际烹饪和营养教育。
（A）医学教育机构。（B）教学厨房。
（A）医学受训者。（B）受训者、医务人员和患者。
（A）在确定的 212 项引文（涉及 1698 名受训者）中，有 11 项研究符合纳入标准。总体效应大小为 9.80（95%CI（7.15，12.45）和 95%CI（6.87，13.85）；P<0.001），与机器学习（ML）增强的结果相当。最高质量研究中需要治疗的人数为 12 人。（B）从表现最佳的研究中采用实际烹饪和营养教育课程，让医学受训者和医务人员在同一课程中教授患者（涉及 5847 名患者）。与单独接受标准医疗保健和教育相比，该干预措施显著增加了居民/研究员（OR 10.79，95%CI（4.94，23.58）；P<0.001）和学生（OR 9.62，95%CI（5.92，15.63）；P<0.001）、医务人员（OR 5.19，95%CI（3.23，8.32），P<0.001）和患者（OR 2.48，95%CI（1.38，4.45）；P=0.002）获得更优饮食的可能性，结果与 ML 一致。
本研究表明，医学受训者和医务人员可以通过提供营养咨询来改善患者的饮食，这种方式具有临床和成本效益，并且可能同时促进社会公平。
