References of "COUCKE, Philippe"
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See detailEtude pilote : évaluation de l'impact de l'utilisation de l'imagerie médicale comme outil d'éducation thérapeutique du patient en radiothérapie
Kirkove, Delphine ULiege; BARTHELEMY, Nicole ULiege; COUCKE, Philippe ULiege et al

Conference (2021, May 28)

Introduction Le cancer du poumon constitue un problème de Santé Publique du fait de sa fréquence et sa mortalité élevée. Habituellement traité par radiothérapie, combinée ou non avec de la chimiothérapie ... [more ▼]

Introduction Le cancer du poumon constitue un problème de Santé Publique du fait de sa fréquence et sa mortalité élevée. Habituellement traité par radiothérapie, combinée ou non avec de la chimiothérapie, le patient peut présenter des effets secondaires et un retentissement psycho-affectif important. Même s’il reçoit de l’information, l’utilisation des images médicales personnelles en éducation thérapeutique est peu étudiée. Cette communication présente l’évaluation de l’intervention selon Kirkpatrick. L’objectif principal concerne l’impact en terme d’anxiété et de dépression. Les objectifs secondaires concernent les autres niveaux : la satisfaction, le sentiment d’implication, les connaissances rapportées, la perception de se sentir préparé et l’adhésion thérapeutique. Méthode Une étude expérimentale de type « essai contrôlé randomisé » a été menée de façon mono-centrique afin de suivre des patients adultes, porteurs d’une pathologie cancéreuse traitée par radiothérapie thoracique, sur quatre périodes de temps. Le recrutement des patients s’est déroulé entre novembre 2019 et mars 2020. Le groupe contrôle a reçu oralement les informations données usuellement par le radiothérapeute. En plus de celles-ci, le groupe expérimental a bénéficié d’une intervention consistant en la visualisation de ses propres images de CT-Scanner combinées à la dosimétrie, via le programme informatique « Stone of Orthanc », accompagnée d’explications personnalisées du radiothérapeute selon un scénario standardisé. Le critère de jugement principal a été évalué par le questionnaire validé HADS « Hospital Anxiety And Depression Scale », complété par une échelle visuelle analogique de l’anxiété aux différents temps. Les critères secondaires ont été évalués via différents questionnaires créés spécifiquement pour cette étude. Résultats L’échantillon était composé d’un total de 45 patients. La crise du COVID-19 a prématurément interrompu la collecte des données. Au final, seules les données de quinze patients ont pu être utilisées. Bien que non-significatif, le groupe expérimental a montré un gain de connaissance plus important (47.5%) entre le T1 et le T3 que le groupe contrôle (35%) (p = 0.345), ainsi qu’une diminution plus importante des scores liés à l’anxiété (p = 0.577). Les résultats de l’EVA indiquent une tendance commune : le niveau d’anxiété augmente au T2 pour diminuer au T3 avec un niveau plus bas dans le groupe expérimental (0.65) que dans le groupe contrôle (1.00). Un paramètre présente une différence significative entre le T1 et le T3 : le score de dépression (p = 0.043) avec une diminution plus importante dans le groupe expérimental (-9.52%) que dans le groupe contrôle (aucune différence). Les résultats des autres paramètres sont restés similaires dans les deux groupes. Discussion Cette étude indique des résultats prometteurs pour l’utilisation de l’imagerie médicale au service de l’éducation thérapeutique du patient, notamment par l’individualisation des contenus. Les travaux futurs s’attacheront à confirmer ces constats sur une plus grande population. [less ▲]

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See detailLa médecine du futur. Dans la tourmente, l’industrie pharma se réinvente. Partie 2. Les opportunités
COUCKE, Philippe ULiege

in Revue Médicale de Liège (2021), 76(4), 292-296

In the first article we described how pharmaceutical industry is facing major challenges in general. In this second part, we intend to focus on new concepts and developments, which might sound futuristic ... [more ▼]

In the first article we described how pharmaceutical industry is facing major challenges in general. In this second part, we intend to focus on new concepts and developments, which might sound futuristic", for most of us. However, this seems definitely "work in rapid progress ", especially concerning, for example, the use of the pharmacogenome (prerequisite for treatment personalization), "clever" medication, 3D printind and labelling with QR code. The futur is bright but we cannot omit to quote the ecer growing role of incumbent actors, both in the fields of medication production as well as distribution. [less ▲]

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See detailComment améliorer la radiothérapie ? évolutions teChnologiques et radiothérapie de demain
Colin, Gilles ULiege; COUCKE, Philippe ULiege

in Revue Médicale de Liège (2021), 76(5-6), 362-368

Radiotherapy established itself in the 20th century as an essential modality in the fight against cancer. The major technological advances of the last decades have allowed a considerable improvement in ... [more ▼]

Radiotherapy established itself in the 20th century as an essential modality in the fight against cancer. The major technological advances of the last decades have allowed a considerable improvement in the therapeutic window. They have also paved the way for stereotactic radiotherapy and new indications. The aim of this article is to enable readers to understand external radiotherapy in 2021 and to understand the challenges of tomorrow. Three areas of improvement in the discipline will be described, the optimization of the prescribed therapeutic dose, the improvement of the distribution of this dose and, finally, the better understanding of radiobiology. For each of these axes, the current implications will be described as well as those which could/should have a major impact on the radiotherapy. FLASH radiotherapy will also be discussed. [less ▲]

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See detailLa médecine du futur. Dans la tourmente, l’industrie pharma se réinvente. Partie 1 : Les défis
COUCKE, Philippe ULiege

in Revue Médicale de Liège (2021), 76

The pharmaceutical industry faces, as many other public sectors, a significant deficit in trust (medication considered too expensive, not always readily available, even if it is deemed essential, lack of ... [more ▼]

The pharmaceutical industry faces, as many other public sectors, a significant deficit in trust (medication considered too expensive, not always readily available, even if it is deemed essential, lack of financial transparency). Moreover, we are more than very surprised by the lack of efficiency (colossal investments, compared to the modest final output). Not a single human activity sector can afford the luxury of such a situation. Int these momentsof doubtsn industrial leaders are pushed to reivent the whole sector , starting from research and development, through production and commercizlization, to finish with retail. They are massievely investing in new disruptive technologies (artificial intelligence , connected health, big data), redesigning the way clinical trials are elaborated and performed. [less ▲]

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See detailMédecine de précision en oncologie : où en sommes-nous ?
COUCKE, Philippe ULiege

in Revue Médicale de Liège (2021), 76(5-6), 380-386

The «one size fits all» approach is seriously challenged by rapid progression of medical knowledge, especially in the field of individual genome expression. It is currently known that the anti-tumour ... [more ▼]

The «one size fits all» approach is seriously challenged by rapid progression of medical knowledge, especially in the field of individual genome expression. It is currently known that the anti-tumour effect of a given treatment and possible side effects at the level of healthy tissues, can at least partly be predicted and explained by individual variations of gene expression. However, most of us realize that these differences in response are also linked to a variety of other individual characteristics, such as for example the environment and socio-economic factors. Without any possible doubt, there are multiple problems (technical, administrative, financial, cultural and ethical) to be solved, before we witness the real irruption of precision medicine and its holistic individualized approach in our daily oncological practice. It has to start with an international effort, disregarding borders of individual countries, in order to obtain very large amounts of data (with a high degree of variability to avoid bias). This holistic approach, at both societal and individual levels, is the entrance door for a personalized approach in care, whether this is curative, predictive or preventive [less ▲]

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See detailLa radiothérapie palliative, c’est aussi notre rayon !
Lamande, Maréva ULiege; Lallemand, François ULiege; BEN MUSTAPHA, Selma ULiege et al

in Revue Médicale de Liège (2021), 76(5-6), 375-379

Radiotherapy (RT), both with a curative and a palliative intent, is one of the cornerstones of oncological treatments. A variety of symptoms linked to cancer can be relieved with RT (such as pain ... [more ▼]

Radiotherapy (RT), both with a curative and a palliative intent, is one of the cornerstones of oncological treatments. A variety of symptoms linked to cancer can be relieved with RT (such as pain, bleeding, compression exerted by a tumour lesion…). Very often, palliative RT is proposed when other medical treatments (painkillers, morphine…) are no longer efficient, or the patient does not tolerate them anymore. Palliative RT is an integral part of the global supportive oncological care. Indeed, patients’ wishes and prognosis are taken into account in each and every step of the treatment pathway. Every treatment deserves an individualized approach and benefits from the best available techniques. [less ▲]

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See detailRadiomique et automatisation en RadiothéRapie : un duo gagnant !
COUCKE, Philippe ULiege

in Revue Médicale de Liège (2021), 76(5-6), 369-374

Cancer incidence is steadily progressing worldwide, in parallel with the aging of the population. Workload is increasing constantly, especially in the fields of oncology and radiotherapy. This is ... [more ▼]

Cancer incidence is steadily progressing worldwide, in parallel with the aging of the population. Workload is increasing constantly, especially in the fields of oncology and radiotherapy. This is particularly worrysome, as there is a general shortage of skilled professionals in the field (for example in medical physics). Moreover, every single patient does represent an enormous amount of data issued from a wide range of sources. This is especially true as far a medical imaging is concerned. Extraction of morphological data (anatomical location and extent of the tumour) and functional data (tumour biology and metabolism in general) becomes laborious. Moreover, images contain information which cannot be discerned by the human eye. Therefore, to handle shortage of human resources and transform this enormous amount of data automatically, artificial intelligence becomes a «must have». We intend to highlight the growing importance of radiomics as a cornerstone in automation of processes in radiotherapy, especially for treatment planification and a more personalized individualized treatment approach. [less ▲]

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See detailIncidence, risk factors, and CT characteristics of radiation recall pneumonitis induced by immune checkpoint inhibitor in lung cancer.
COUSIN, François ULiege; DESIR, Colin ULiege; BEN MUSTAPHA, Selma ULiege et al

in Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology (2021), 157

BACKGROUND AND PURPOSE: Radiation recall pneumonitis (RRP) is a delayed radiation-induced lung toxicity triggered by systemic agents, typically anticancer drugs. Immune checkpoint inhibitors (ICIs) have ... [more ▼]

BACKGROUND AND PURPOSE: Radiation recall pneumonitis (RRP) is a delayed radiation-induced lung toxicity triggered by systemic agents, typically anticancer drugs. Immune checkpoint inhibitors (ICIs) have recently been identified as potential causal agents of RRP but its real incidence and potential risk factors remain unknown. MATERIALS AND METHODS: Medical records and CTs of patients treated with programmed death 1 (PD-1) or programmed death ligand 1 (PD-L1) inhibitors for advanced lung cancer between 2014 and 2019 at our tertiary center, and who had a previous history of lung irradiation were retrospectively analyzed. We identified RRP as lung CT modifications occurring in the irradiation field >6 months after conventionally fractionated radiotherapy completion and >1 year after stereotactic body radiation therapy. Clinical and dosimetric data were analyzed to identify potential risk factors for RRP. RESULTS: Among 348 patients treated with ICIs, data from 80 eligible patients were analyzed (median age, 69 years [interquartile range, 11]; 45 men). Fifteen patients (18.8%) presented with RRP. Median time between end of radiotherapy and RRP was 450 days (range, 231-1859). No risk factor was significantly associated with RRP. ICI-related pneumonitis was associated with RRP in 33.3% of cases (p = 0.0021), developing either concomitantly or after RRP. Incidence of grade ≥ 3 pneumonitis in the RRP population was 13.3 %. CONCLUSION: We demonstrated a high incidence of RRP (18.8%) in our population of previously irradiated patients treated with ICIs for lung cancer. We identified no risk factors for RRP, but an association was noted between RRP and ICI-related pneumonitis. [less ▲]

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See detailUn nouveau sytème de soins s'impose
COUCKE, Philippe ULiege

in Louvain Medical (2020), 139

Notre système de soins n’est plus durable, même à court terme. Un nouvel écosystème doit impérativement remplacer l’existant. Les mots clés de ce nouvel écosystème sont : internet des objets, big data ... [more ▼]

Notre système de soins n’est plus durable, même à court terme. Un nouvel écosystème doit impérativement remplacer l’existant. Les mots clés de ce nouvel écosystème sont : internet des objets, big data, intelligence artificielle, cloud et blockchain. Dans un tel système, le patient devient connecté et génère une énorme quantité de données. Seule l’intelligence artificielle permet d’en extraire l’information utile qui nous servira à affiner le diagnostic et à faire des choix de traitement pertinent et personnalisé. La démographie nous oblige à connecter les patients et à délocaliser les soins, tant au niveau de la première ligne qu’au niveau des soins spécialisés. La connexion permet un flux de données caractérisé par la vitesse d’acquisition, le volume, la variabilité et il nous incombe d’en assurer la véracité pour ne pas biaiser l’intelligence artificielle. La robotisation s’impose partout, y compris dans le monde des soins. Faisons le pari qu’elle permette un retour vers les vraies valeurs des métiers liés aux soins comme la communication, le travail en équipe et l’empathie. [less ▲]

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See detailRepenser les soins de santé post-COVID-19
VANDENBOSCH, Kristel ULiege; LASRI, Saadia ULiege; GILLET, Pierre ULiege et al

in Revue Médicale de Liège (2020)

The health crisis linked to the coronavirus pandemic (COVID-19) has forced society and hospitals in particular to adapt and reform. Teamwork between hospitals, even beyond the networks, helped them to ... [more ▼]

The health crisis linked to the coronavirus pandemic (COVID-19) has forced society and hospitals in particular to adapt and reform. Teamwork between hospitals, even beyond the networks, helped them to deal with the crisis. The medical and nursing staff had to learn to work differently and differentiate urgent from non-urgent care. But the patient also had to change his/her behaviour. Access to hospitals has been divided between a separate COVID and non-COVID route in order to avoid contamination. Telemedicine has become a daily way of communicating between doctors and patients. Telephone consultations have been set up with reimbursement by social security. However, these actions and innovations should not end with the crisis but, on the contrary, be a lever to rethink the role of hospitals, and our health care system more generally. [less ▲]

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See detailLa pandémie COVID-19 : une formidable opportunité pour les technologies digitales
Coucke, CH; COUCKE, Philippe ULiege

in Revue Médicale de Liège (2020)

: Nowadays, we are facing a global health crisis. The infectious agent, the virus SARS-CoV-2, has some clinical and pathological characteristics which have been described extensively throughout published ... [more ▼]

: Nowadays, we are facing a global health crisis. The infectious agent, the virus SARS-CoV-2, has some clinical and pathological characteristics which have been described extensively throughout published medical literature. The pandemic outbreak arises in a very particular period. Never before, our political disorganization and lack of collaboration has been highlighted as it was during the present health care crisis. Our health care system is shaking because of the lack of sufficient human and financial resources. However, technological changes, and especially remote health (teleconsultations and remote monitoring) are disrupting the whole ecosystem. We intend to illustrate that the COVID outbreak offers a unique opportunity to accelerate acceptance of these rapid technological changes, which are anyway unavoidable. Teleconsultations and remote monitoring, which both appeared as a devil out of the box from nowhere, at least for some care providers in the health care landscape, are there to stay. [less ▲]

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See detailLa médecine du futur professionnels de l'imagerie médicale et spécialités annexées : une remise en question s’impose !
COUCKE, Philippe ULiege; DELEUSE, P

in Revue Médicale de Liège (2020), 75

: Nowadays, we are facing an overwhelming amount of public announcements concerning the rise of artificial intelligence (AI) in the world of medical imaging (including radiology, nuclear medicine and ... [more ▼]

: Nowadays, we are facing an overwhelming amount of public announcements concerning the rise of artificial intelligence (AI) in the world of medical imaging (including radiology, nuclear medicine and radiotherapy). While most of the applications are still limited to specific niches, there is a general trend to build real transversal platforms. Multiple industrial players, in collaboration with the clinicians in the field, are striving to build those platforms in order to offer plenty of use cases of AI for several purposes and needs (screening/detection, diagnosis and prediction). It is already undeniable that AI far exceeds human capabilities in terms of resolution, speed of image analysis and efficiency. Negative attitudes and skepticism from concerned professionals should be banned. Collaboration with data scientists and engineers for the large scale development and implementation should be pushed forward for the benefit of both patients and payers. [less ▲]

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See detailLa médecine du futur. Poser un diagnostic: avez-vous du flair?
COUCKE, Philippe ULiege

in Revue Médicale de Liège (2019)

Since centuries, the human clinical observation skills include our capacity to smell. However, it is well known that this particular capacity is largely outraced by our lovely dogs. Some centers around ... [more ▼]

Since centuries, the human clinical observation skills include our capacity to smell. However, it is well known that this particular capacity is largely outraced by our lovely dogs. Some centers around the world are actively training these dogs in order to provide a correct diagnosis for particular diseases. This clinical observation has given rise to intensive development of digital tools which are able to recognize patterns of volatile organic compounds (VOC’s) in the exhaled air, but not only. It is not a single VOC which is important but an association - a specific pattern - which at the end represents the signature of a disease. This opens the door widely to applications both in the diagnostic field, as well as for follow-up of treated patients. [less ▲]

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See detailLa médecine du futur. Laennec contre Forbes : match nul ! Comment la technologie nous aide à interpréter l’auscultation
Coucke, Philippe ULiege

in Revue Médicale de Liège (2019), 74

For at least two centuries, the stethoscope has served as an essential cornerstone in clinical semiology. The sounds of heart and lung have been used for the differential diagnosis by multiple generations ... [more ▼]

For at least two centuries, the stethoscope has served as an essential cornerstone in clinical semiology. The sounds of heart and lung have been used for the differential diagnosis by multiple generations of physicians. One can argue today that our hearing and cognitive capacities are largely outraced by the development of new techniques with embarked artificial intelligence. This latter is able to recognize and differentiate with high precision cardiac and pulmonary sounds. [less ▲]

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See detailVirtual reality: A tool in the treatment of anxiety in stereotaxic radiotherapy?
Gamin, Nicolas ULiege; JANSEN, Nicolas ULiege; COUCKE, Philippe ULiege et al

Poster (2019, May 14)

Stereotaxic radiotherapy (SR) is an effective treatment for many types ofcancer but seems to cause anxiety. The purpose of this study is to determine whether experiencing the medical procedure by using ... [more ▼]

Stereotaxic radiotherapy (SR) is an effective treatment for many types ofcancer but seems to cause anxiety. The purpose of this study is to determine whether experiencing the medical procedure by using immersive virtual video can reduce preoperative anxiety. The experimental group (n=10) received information about the intervention and was exposed three times to the procedure before the SR. Two immersions took place in the days precedingthe intervention and the third took place just before the SR. The control group (n=10) only received information about the intervention. The STAI Y-A scale was used to measure state anxiety before and after each virtual immersion in the experimental group and just before and after the SR in both groups. We observed a similar decrease in anxiety across groups, which did not differ between them. Despite this result, it is important to point out that the experimental group reported a significant decrease in anxiety after the two immersions of day 1. The third immersion was not accompanied by a decrease of it. In conclusion, virtual reality seems useful in the treatment of preoperative anxiety, but its use is not enough to neutralize patient’s anxiety when approaching treatment [less ▲]

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See detailThe status of radiation oncology (RO) teaching to medical students in Europe
BEN MUSTAPHA, Selma ULiege; Meijnders, paul; COUCKE, Philippe ULiege et al

in Clinical and Translational Radiation Oncology (2019)

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See detailLe débat se crispe autour de CRISPR! Ne jetons pas le bébé avec l'eau du bain...
COUCKE, Philippe ULiege

in Onco: Revue Multidisciplinaire d'Oncologie (2019), 13

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See detailMoyens numériques pour améliorer l'adhésion au traitement oral
Coucke, Philippe ULiege

in Onco: Revue Multidisciplinaire d'Oncologie (2019), 13

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