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Öğe A New Scoring System for the Evaluation of Ibrutinib-Associated Arrhythmias in Chronic Lymphocytic Leukemia: The ACEF Score(Galenos Publ House, 2024) Koyuncu, Ilhan; Koyuncu, Betuel; Ugur, Mehmet Can; Koyun, Emin; Senoz, Oktay; Dogdus, Mustafa; Bilgir, OktayObjective: Bruton tyrosine kinase inhibition in cardiac tissue causes inhibition of the PI3K-AKT signaling pathway, which is responsible for protecting cardiac tissue during stress. Therefore, there is an increase in the risk of arrhythmia. This study explores the prediction of that risk with the Age-Creatinine-Ejection Fraction (ACEF) score as a simple scoring system based on the components of age, creatinine, and ejection fraction. Materials and Methods: Patients diagnosed with chronic lymphocytic leukemia (CLL) and receiving ibrutinib treatment for at least 1 year were evaluated with echocardiography and Holter electrocardiography and the results were compared with a control group of CLL patients who had not received treatment. ACEF score was calculated with the formula age/left ventricular ejection fraction+1 (if creatinine >2.0 mg/dL). Results: When the arrhythmia development of the patients was evaluated, no statistically significant difference was found between the control and ibrutinib groups in terms of types of arrhythmias other than paroxysmal atrial fibrillation (PAF). PAF was found to occur at rates of 8% versus 22% (p=0.042) among ibrutinib non -users versus users. For patients using ibrutinib, an ACEF score of >1.21 predicted the development of PAF with 77% sensitivity and 75% specificity (area under the curve: 0.830, 95% confidence interval: 0.698-0.962, p<0.001). Conclusion: The ACEF score can be used as a risk score that predicts the development of PAF in patients diagnosed with CLL who are scheduled to start ibrutinib.Öğe Atherogenic indexes versus hematologic inflammatory indexes: What is the most useful predictor of coronary slow flow?(Bayrakol Medical Publisher, 2021) Dindas, Ferhat; Koyun, Emin; Cerik, Idris Bugra; Sahin, Anil; Kilit, Celal; Dogdus, MustafaAim: Previous studies reported that inflammation and atherosclerosis are linked to coronary slow flow (CSF). The predominant pathological mechanism has not been elucidated yet. Hence, we aimed to compare hematologic inflammatory and atherogenic indexes simultaneously between patients with normal coronary flow (NCF) and CSF. Material and Methods: In a single-center retrospective analysis, 91 consecutive NCF patients and 90 consecutive CSF patients constituted two groups according to Thrombolysis in Myocardial Infarction frame count (TFC). Hematological indexes consist of the neutrophil-lymphocyte ratio (NLR), the lymphocyte to monocyte ratio (LMR), and the platelet-lymphocyte ratio (PLR), and the atherogenic indexes consist of an atherogenic index of plasma (AIP), atherogenic coefficient (AC), and Castelli's risk index (CRI). Baseline clinical parameters were compared beside the indexes. Results: NLR, LMR, PLR were similar in groups. AIP, AC and CRI were significantly higher in the CSF group (p<0.05). In correlation analysis, only CRI has significantly positive correlation with mean TFC (r: 0.419 p <0.001). In multivariate regression analysis, CRI was found as independently predictor of CSF (Odds ratio = 2.74, 95% CI = 1.21-6.207; p=0.016). Discussion: An elevated CRI may be an independent predictor for the presence of CSF. Additionally, it can be said that the inflammatory activity in CSF is transformed into atherosclerotic structures.Öğe Electrocardiographic Prognostic Marker in Pulmonary Arterial Hypertension: RS Time(Arquivos Brasileiros Cardiologia, 2024) Koyun, Emin; Sahin, Anil; Yilmaz, Ahmet; Dindas, Ferhat; Cerik, Idris Bugra; Koyun, Gorkem BernaBackground: Pulmonary hypertension is a condition that involves the remodeling of the right ventricle. Ongoing remodeling is also associated with disease prognosis. During the restructuring process, complex changes such as hypertrophy and dilatation may also be reflected in electrocardiographic parameters. Objectives: Our study aimed to investigate the relationship between prognosis and electrocardiographic parameters in patients with pulmonary arterial hypertension. Methods: The study was designed retrospectively and included patients diagnosed with pulmonary arterial hypertension between 2010 and 2022. The patients were divided into two groups based on their survival outcome. Various parameters, including electrocardiographic, demographic, echocardiographic, catheter, and blood parameters, were compared between the two groups. A p-value of <0.05 was considered statistically significant. Results: In the multivariate Cox analyses, the parameters that were found to be independently associated with survival were the 6-minute walk test, mean pulmonary artery pressure, presence of pericardial effusion, and time between the beginning of the QRS and the peak of the S wave (RS time) (p<0.05 for each). Of all the parameters, RS time demonstrated the best diagnostic performance (AUC:0.832). In the survival analysis, a significant correlation was found between RS time and survival when using a cut-off value of 59.5 ms (HR: 0.06 [0.02-0.17], p < 0.001). Conclusions: According to the results of our study, a longer RS time is associated with poor prognosis in patients with pulmonary arterial hypertension. We can obtain information about the course of the disease with a simple, non-invasive parameter.Öğe Electrocardiographic Prognostic Marker in Pulmonary Arterial Hypertension: RS Time [2](Arquivos Brasileiros Cardiologia, 2024) Koyun, Emin; Sahin, Anil; Yilmaz, Ahmet; Dindas, Ferhat; Cerik, Idris Bugra; Koyun, Gorkem BernaBackground: Pulmonary hypertension is a condition that involves the remodeling of the right ventricle. Ongoing remodeling is also associated with disease prognosis. During the restructuring process, complex changes such as hypertrophy and dilatation may also be reflected in electrocardiographic parameters. Objectives: Our study aimed to investigate the relationship between prognosis and electrocardiographic parameters in patients with pulmonary arterial hypertension. Methods: The study was designed retrospectively and included patients diagnosed with pulmonary arterial hypertension between 2010 and 2022. The patients were divided into two groups based on their survival outcome. Various parameters, including electrocardiographic, demographic, echocardiographic, catheter, and blood parameters, were compared between the two groups. A p-value of <0.05 was considered statistically significant. Results: In the multivariate Cox analyses, the parameters that were found to be independently associated with survival were the 6-minute walk test, mean pulmonary artery pressure, presence of pericardial effusion, and time between the beginning of the QRS and the peak of the S wave (RS time) (p<0.05 for each). Of all the parameters, RS time demonstrated the best diagnostic performance (AUC:0.832). In the survival analysis, a significant correlation was found between RS time and survival when using a cut-off value of 59.5 ms (HR: 0.06 [0.02-0.17], p < 0.001). Conclusions: According to the results of our study, a longer RS time is associated with poor prognosis in patients with pulmonary arterial hypertension. We can obtain information about the course of the disease with a simple, non-invasive parameter.Öğe Employment Preferences of Cardiologists in Türkiye: A Discrete Choice Experiment(Kare Publ, 2024) Cerik, Idris Bugra; Koyun, Emin; Kiyak, Yavuz Selim; Budakoglu, Isil Irem; Dindas, Ferhat; Coskun, OzlemObjective: The homogeneous distribution of physicians is important for ensuring patients' access to health services. To encourage physicians to work in underserved areas, policymakers create incentives. Understanding physicians' employment preferences is essential when developing these incentive packages. This study aims to quantitatively reveal the preferences of cardiologists in T & uuml;rkiye using a discrete choice experiment (DCE). Methods: A DCE questionnaire was distributed electronically to all cardiologists in T & uuml;rkiye. It included 14 different pairs of hypothetical job offers based on seven parameters likely to influence their employment preferences. The data were analyzed using a conditional logit model. The coefficients (CEs) of conditional logistic regression and the willingness -to -accept (WTA) values were calculated. Results: The analysis included 278 cardiologists. It revealed that the most influential parameter was location (CE: 2.86). To move to an undesirable location, the average participant would require an earnings increase of at least 123.3% relative to the average potential earnings of a cardiologist. Other parameters included availability of suitable facilities (CE: 1.07, WTA: 46.3%), harmony with co-workers (CE: 0.92, WTA: 39.61%), working conditions (CE: 0.68, WTA: 29.26%), and the number of night shifts (CE: 0.61, WTA: 26.34%). Conclusion: Location emerged as the most important factor in the employment preferences of cardiologists in T & uuml;rkiye. However, several other monetary and non -monetary factors were also influential, suggesting that policymakers should adopt a holistic approach when developing incentives for cardiologists.Öğe Kist Hidatik Hastalığına Sekonder Olarak Gelişen Pulmoner Hipertansiyon Olgusu(2023) Koyun, Görkem Berna; Doğan, Ömer Tamer; Koyun, EminKist hidatik hastalığı endemik bir hastalıktır ve ciddi komplikasyonlara yol açarak fatal sonuçlar doğurabilir. Kist hidatik hastalığının ciddi komplikasyonları arasında intra- kardiyak kitleler ve pulmoner emboli de olabilir. Pulmoner emboliye bağlı olarak pul- moner arter basıncı artabilir ve tekrarlayan emboliler sonucunda pulmoner arteryel hipertansiyona yol açabilir. Burada, kist hidatik hastalığı olan bir hastanın kist hidatiğe bağlı olarak pulmoner emboli geçirmesi ve kronik süreçte buna bağlı olarak kronik tromboembolik pulmoner hipertansiyona yol açtığı bir olgu sunuldu.Öğe Koroner Arter Hastalığı Varlığında Periferik Arter Hastalığının Prediktörleri: Plazma Aterojenik İndeks ve Trigliserit Glikoz İndeksi(2023) Koyun, Emin; Şahin, Anıl; Dindaş, Ferhat; Çerik, İdris Buğra; Kanal, Yücel; Karabey, ErcanAmaç: Koroner arter hastalığı olan hastalarda periferik arter hastalığını öngörebilecek basit uygulanabilir parametrelere ihtiyaç va rdır. Aterojenik plazma indeksi ve trigliserit glikoz indeksi ateroskleroz ile ilişkili parametreler olup bu parametrelerin koroner a rter hastalğı olanlarda periferik arter hastalığı öngördürebileceği hipotezi ile çalışmaya başladık. Gereç ve Yöntem: Geriye dönük bir çalışma olup çalışmaya 96 hasta dahil edildi. Hastalar; sadece koroner arter hastalığı olanlar ile ko roner ve periferik arter hastalığı birlikte bulunan hastalar olmak üzere iki gruba ayrıldı. Her iki grup arasındaki değişkenler incelendi. Bulgular: Plazma aterojenik indeks ve trigliserit glikoz indeksi her iki grupta karşılaştırıldı. Yapılan regresyon analizinde AIP ve trigliserit glikoz indeksinın periferik arter hastalığı öngörebilen parametreler olduğu sonucu bulundu. Sonuç: Plazma aterojenik indeks ve trigliserit glikoz indeksi, koroner arter hastalığında periferik arter hastalığını öngörebilen para met relerdir. Koroner arter hastalarında bu indeksler rutin olarak kullanılması önerilebilir. Böylelikle koroner arter hastalarında periferik ar ter hastalığının erken tanı ve tedavisi hızlıca yapılabilecektir.Öğe Mortality predictor in heart failure patients with preserved ejection fraction: pulmonary artery pulsatility index(Taylor & Francis Ltd, 2024) Koyun, Emin; Sahin, Anil& Idot;ntroduction: The pathophysiology of heart failure with preserved ejection fraction has not been clearly elucidated. Therefore, there is not enough information about the prediction of poor prognosis in these patients. Our aim is to investigate whether the pulmonary artery pulsatile index, derived from right heart catheterisation parameters, is associated with mortality in these patients. Materials and methods: The study was designed retrospectively. Patients who underwent right heart catheterisation between 2016 and 2023 and were diagnosed with heart failure with preserved ejection fraction were included in the study. The patients were divided into 2 groups. Dead patients were included in the first group, and surviving patients were included in the second group. Basic characteristics, right heart catheterisation results, pre-catheter blood and echocardiography parameters, and pulmonary artery pulsatile index were compared between both groups. Results: Pulmonary artery pulsatile index, mean pulmonary artery pressure, and body mass index were found to be independent predictors of mortality in heart failure patients with preserved ejection fraction. A PAPi value of <2.84 was found to have 76.2% sensitivity and 77% specificity in predicting mortality in heart failure patients with preserved ejection fraction. Conclusion: This study shows how important the pulmonary artery pulsatile index is in predicting mortality in heart failure patients with preserved ejection fraction. Since low levels of pulmonary artery pulsatile index at the time of diagnosis may predict poor prognosis, importance should be given to follow-up and treatment in these patients. Routine use of this index may contribute to reducing mortality and morbidity in patients.Öğe New prognostic markers in pulmonary arterial hypertension: CRP to albumin ratio and uric acid(Pergamon-Elsevier Science Ltd, 2022) Cerik, Idris Bugra; Dindas, Ferhat; Koyun, Emin; Dereli, Seckin; Sahin, Anil; Turgut, Okan Onur; Gul, IbrahimIntroduction: Idiopathic pulmonary hypertension(IPAH) is a rare disease that causes severe morbidity and mortality despite advances in treatment management. Evaluating the prognosis of the disease is critical in determining therapeutic approaches. We aimed to evaluate the prognostic significance of C-reactive protein/albumin ratio (CAR) and uric acid, which is an easily applicable and inexpensive parameter in patients with IPAH. Methods: Seventy-two IPAH patients and 99 consecutive non-IPAH patients as a control group were enrolled in the study retrospectively. Right heart catheterization(RHC), echocardiography, and laboratory parameters of the two groups and those who died and survived among the IPAH patients were compared. Results: IPAH and control group were compared at the first stage and CAR (1.98(0.28-10.74), 0.75(0.22-4.7), respectively;p < 0.01) and uric acid (0.33(0.19-0.87), 0.3(0.11-0.48) mmol/L, respectively; p = 0.03) values were significantly higher in the pulmonary hypertension group compared to the control group. Compared with the surviving IPAH patients, CAR (4.60(1.39-10.74),1.54(0.28-6.74),respectively;p < 0.001) and uric acid levels (0.458(0.26-0.87), 0.315(0.19-0.56) mmol/L, respectively; p < 0.001) were significantly higher in the group of patients who died. In the multivariate Cox regression models uric acid(p < 0.001) and CAR(p < 0.001) were found to be associated with survival time. Receiver operating characteristic curves (ROC) analyses showed that > 1.54 CAR value (AUC = 0.81,Sens:85.7%,Spec:56.9%,p < 0.001) and > 5.85 mg/dL (>0.348 mmol/L) uric acid value (AUC = 0.864, Sens:85.7%, Spec:78.4%, p < 0.001) are strong predictors for mortality. Conclusion: In this study, we showed that simple markers such as CAR, which augment the inflammation marker feature of CRP, and uric acid can give prognostic information in PAH patients.Öğe Pulmoner hipertansiyon hastalarında mortalite ile elektrokardiyografik parametrelerin ilişkisi(Sivas Cumhuriyet Üniversitesi, 2023) Koyun, Emin; Şahin, AnılPulmoner hipertansiyon özellikle sağ ventrikül üzerinde yeniden şekillenme ile seyreden bir hastalıktır. Bu yeniden şekillenme sürecinde oluşabilen özellikle hipertrofi ve dilatasyonlar elektrokardiyografik parametrelere de yansıyabilmektedir. Bizde çalışmamızda pulmoner hipertansiyon hastalığında mortalite ile elektrokardiyografik parametreler arasındaki ilişkiyi araştırmayı amaçladık. Bu çalışma retrospektif bir çalışma olarak dizayn edildi. Çalışmaya Sivas Cumhuriyet Üniversitesi Tıp Fakültesi Kardiyoloji Anabilim Dalı'nda 2010-2022 yılları arasında pulmoner arteriyel hipertansiyon tanısı konmuş veya bu tanı ile takip edilmiş ve hala takip edilmekte olan hastalar alındı. Bu hastaların tanı anındaki elektrokardiyografik parametreleri incelendi. Hastaların ölü ya da sağ olup olmadığı hastane kayıtlarından veya telefon ile iletişime geçilerek öğrenildi. Hastalar ölenler ve sağ olanlar şeklinde iki gruba ayrılarak elektrokardiyografik verileri karşılaştırıldı. Çalışmaya katılan hastalar arasında ölen grupta elektrokardiyografik parametreler arasında RS ve QRS süresi yaşayan hastalara göre daha uzun olarak bulundu (p<0,001, p=0,001). Yapılan çok değişkenli Cox regresyon analizinde ise elektrokardiyografik parametrelerden yalnızca RS süresi ölen grupta anlamlı olarak daha uzun saptandı (p<0,001). PAH hastalarının tanı ve takibinde rutin risk parametrelerine ek olarak prognozu ön gördürecek ek parametreler kullanılabilir. Çalışmamızdaki bulgular ışığında pulmoner arteriyel hipertansiyon hastalarında tanı anındaki RS süresinin uzun olmasının mortalite ile ilişkili olabileceği ve takipte risk tayininde kullanılabileceği düşünülmektedir.Öğe Screening Tests Predicting Cancer Metastasis in the Etiology of Pericardial Effusion: HALP Score and PNI(Arquivos Brasileiros Cardiologia, 2024) Koyun, Emin; Dindas, Ferhat; Sahin, Anil; Cerik, Idris Bugra; Dogdus, MustafaBackground: Cancer screening is absolutely necessary in patients with pericardial effusion, given that cancer is one of the most serious diseases in the etiology of pericardial effusion. In previous studies, it was stated that the systemic immune -inflammation index (SII); the prognostic nutrition index (PNI); and the hemoglobin, albumin, lymphocyte, platelet (HALP) score can produce scores related to cancer. Objectives: This study began considering that these scoring systems could predict cancer in the etiology of patients with pericardial effusion. Methods: This study produced a retrospective analysis of patients who underwent pericardiocentesis between 2006 and 2022. Pericardiocentesis was performed in a total of 283 patients with moderate-to-large pericardial effusion or pericardial tamponade within the specified period. HALP, PNI, and SII scores were calculated according to the peripheral venous blood taken before the pericardiocentesis procedure. The statistical significance level was set at p<0.05. Results: The HALP score proved to be 0.173 (0.125-0.175) in cancer patients and 0.32 (0.20-0.49) in non -cancer patients (p<0.001). The PNI score proved to be 33.1 +/- 5.6 in cancer patients and 39.8 +/- 4.8 in non -cancer patients (p<0.001). Conclusion: The HALP score and PNI proved to be easy and fast cancer screening tests that can predict cancer metastasis in the etiology of patients with pericardial effusion.Öğe Systemic Immune Inflammation Index is a Novel Marker in Predicting the Presence and Severity of Isolated Coronary Artery Ectasia(Sociedade Brasileira de Cardiologia, 2023) Dindas, Ferhat; Koyun, Emin; Turkyilmaz, Erdem; Abacioglu, Ozge Ozcan; Yildirim, Arafat; Sahin, Anil; Dindar, BarisBackground: The underlying pathology of isolated coronary artery ectasia (CE) has not been fully elucidated. Objective: We aimed to examine the relationship between the systemic immune inflammation index (Sıı), which corresponds to the multiplying of the neutrophil-to-lymphocyte ratio (NLR) and the platelet counts, and isolated CE. Method: The retrospective study population included 200 patients with isolated CE, 200 consecutive with obstructive coronary artery disease, and 200 consecutive with a normal coronary artery angiogram. A 2-sided p-value of <0.05 was considered significant. Results: Sıı, NLR, platelet-to-lymphocyte ratio (PLR), and monocyte-to-high density lipoprotein cholesterol ratio (MHR) were significantly higher in the CE group compared with the other groups (all p<0.001). In multivariate analysis, Sıı (p<0.001, OR = 1.005, 95% CI =1.004-1.005) was found to be an independent predictor of isolated CE. In Receiver Operating Characteristic curve analysis, Sıı had a higher Area Under the Curve than NLR, PLR, and MHR. Sıı value of >517.35 has 79% sensitivity, 76% specificity for the prediction of the CE [AUC: 0.832, (p<0.001)]. Sıı had a significant correlation with the number of ectatic coronary arteries and Markis classification (r:0.214 p=0.002; r:-0.195, p=0.006, respectively). Conclusion: To the best of our knowledge, this is the first study that Sıı was significantly associated with isolated CE presence and anatomical severity. © 2023, Sociedade Brasileira de Cardiologia. All rights reserved.Öğe THE RELATIONSHIP BETWEEN DE RITIS SCORE AND RADIAL ARTERY STENOSIS IN PATIENTS UNDERGOING CORONARY ANGIOGRAPHY VIA THE TRANSRADIAL ACCESS(Afyonkarahisar Sağlık Bilimleri Üniversitesi, 2025) Kanal, Yücel; Ağırlar, Murat; Kanal, Hatice Eftal Şeyda; Öncü, Süleyman; Koyun, Emin; Yakut, İdrisOBJECTIVE: While transradial access (TRA) coronary angiography (CAG) is recommended, radial artery stenosis (RAS) remains a significant issue in these patients. In patients with RAS, the reuse of the radial artery for CAG, as a coronary artery bypass graft, or as a conduit for hemodialysis fistula formation can pose a serious problem. The De Ritis score is defined as the ratio between the levels of aspartate transaminase (AST) and alanine transaminase (ALT) in the serum. Our study aimed to assess the relationship between RAS and the De Ritis score. MATERIAL AND METHODS: This retrospective study included a total of 96 patients who underwent elective CAG via the radial artery route in our hospital's catheter laboratory and were subsequently placed under medical follow-up. RESULTS: In our study, the De Ritis score was significantly higher in RAS+ patients than in the RAS- patient group (1.72 vs. 1.10; p=0.006). Multivariate logistic regression analysis demonstrated that the De Ritis score was an independent predictor of RAS (p=0.037). The De Ritis ratio predicted significant RAS with a cut-off point of 1.35, achieving a sensitivity of 70% and a specificity of 79% (AUC: 0.787, 95% CI: 0.643-0.932, p: 0.001). CONCLUSIONS: Our study identified that an elevated De Ritis score is an independent indicator of RAS.Öğe Tıp Eğitiminde Klinik Akıl Yürütme Becerisinin Ölçümü için Türkçede İlk Otomatik Soru Üretimi(Tıp Eğitimini Geliştirme Derneği, 2023) Kıyak, Yavuz Selim; Budakoğlu, Işıl İrem; Coşkun, Özlem; Koyun, EminAmaç: Yüksek kaliteli madde (soru) yazmanın, ciddi miktarlarda kaynak harcamayı zorunlu kılan türden bir iş olduğu söylenebilir. Özellikle üst düzey bilişsel becerileri ölçen, bağlam açısından zengin içerikli çoktan seçmeli soru yazma işlemi saatler harcamayı gerektirebilir. Bu çalışmanın amacı, Otomatik Soru Üretimi (OSÜ) yöntemi kullanılarak Türkçede klinik akıl yürütme becerisinin ölçümüne yönelik olguya dayalı çoktan seçmeli soru üretiminin mümkün olup olmadığını belirlemektir. Yöntem: Gierl vd. tarafından geliştirilen şablon tabanlı OSÜ yöntemi kullanılarak birer bilişsel model ve soru modelinin geliştirilmesinin ardından bir yazılım yardımıyla hipertansiyon konusunu içeren olguya dayalı çoktan seçmeli sorular üretildi. Bilişsel model ve soru modeli, bir tıp doktoru ve bir kardiyolog tarafından, Türk Hipertansiyon Uzlaşı Raporu dikkate alınarak oluşturuldu. Yazılım, Python tabanlı bir kod şeklinde yazıldı. Yazılım geliştirme, kullanıcı arayüzü geliştirmeyi içermiyordu ve yazılım tek seferlik kullanım için kodlandı. Üretilen sorular, MySQL veritabanı kullanılarak kaydedildi. Üretilen bu soruların arasından rastgele seçilen 10 soru, üç konu uzmanı kardiyolog tıp eğiticisi tarafından incelendi. Değerlendirme sürecinde soruların kalitesi kardiyologlar tarafından incelendi. Ayrıca, soruların basit hatırlama düzeyi yerine klinik akıl yürütme becerisi gibi üst düzey bilişsel bir beceriyi ölçüp ölçmediği de değerlendirildi. Bulgular: 1.73 saniyede, hipertansiyon konusunu içeren 1600 çoktan seçmeli soru üretildi. Bazı sorularda minor değişiklik önerisinde bulunmuş olmalarına rağmen, her bir kardiyolog her bir sorunun kabul edilebilir birer soru olduğunu belirtti. Kardiyologlar ayrıca, incelenen her bir sorunun hatırlama düzeyi yerine klinik akıl yürütme becerisini ölçmeye yönelik olduğunu belirtti. Sonuç: Bu çalışma, Türkçede ilk kez tıp eğitimi bağlamında klinik akıl yürütme becerisini ölçmek için otomatik soru üretiminin mümkün olduğunu göstermiştir. Bu artırılmış zekâ yöntemi, diğer beş dilde olduğu gibi Türkçede de soru oluşturmak için kullanılabilir. Bu yöntemin kullanımı, klinik akıl yürütme becerisinin ölçümüne yönelik daha fazla soru elde etmemize yardımcı olabilir. Ayrıca, geleneksel soru yazımı yöntemine göre tıp eğiticilerinin bu süreçte daha az zaman ve çaba harcamalarını sağlayabilir.Öğe What do Turkish, Spanish, and Pakistani medical students value in specialty training positions? A discrete choice experiment(Bmc, 2022) Kiyak, Yavuz Selim; Budakoglu, Isil Irem; Garcia-Estan, Joaquin; Atta, Komal; Coskun, Ozlem; Koyun, EminBackground: The aim of this study was to find out specialty training preferences of senior medical students from three medical schools in Turkey, Spain, and Pakistan. Methods: A Discrete Choice Experiment was carried out using an electronic form for students in three countries in 2021-2022 term. Each choice set in the form consisted of two hypothetical specialty training positions. The attributes were location, earnings, working conditions, personal perspective, quality of education, probability of malpractice, and prestige. Conditional logit model was used to estimate participants' preferences and willingness to accept values. Results: The most valued attribute was personal perspective on specialty area for Turkish and Spanish students, while this attribute was not meaningful for Pakistani students. Turkish students needed a 204% of change in their income for a swap between the specialty that they like and not like. This tradeoff necessitated a 300% change for Spanish students. The most valued attribute for Pakistani students, which was working conditions, necessitated a 97% increase in income to switch from working in good conditions to working in poor conditions. Conclusion: In this first multinational DCE study in the medical education literature, we found the preferences of medical students in Turkey, Spain, and Pakistan are affected to various extents by several factors.
