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A Novel Framework for Extracting Knowledge Management from Business Intelligence Log Files in Hospitals. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12115621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Abstract
This paper proposes a framework to extract knowledge-management elements from business systems in healthcare organizations. According to results of in-depth interviews with experts in the field, a framework is defined, and software was developed to generate log files. Following the application of the Bag of Words (BoW) method on log files of 455 days for feature extraction, the k-means algorithm was used to cluster the feature vectors. The framework was tested with queries for confirmation. The developed framework successfully clustered the generated reports at operational, tactical, and strategic levels to extract knowledge-management elements. This study provides evidence for the knowledge-management pyramid by finding that the generated reports are reviewed mostly at the operational level, then tactical, and then the least at the strategic level. Our framework has the potential to be used not only in the health sector, but also in banking, insurance, and other businesses using business intelligence, especially in accordance with the organization’s goals at operational, tactical, and strategic levels of the knowledge-management pyramid.
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Derakhshan P, Azadmanjir Z, Naghdi K, Habibi Arejan R, Safdarian M, Zarei MR, Jazayeri SB, Sharif-Alhoseini M, Arab Kheradmand J, Amirjamshidi A, Ghodsi Z, Faghih Jooybari M, Mohammadzadeh M, Khazaeipour Z, Abdollah Zadegan S, Abedi A, Oreilly G, Noonan V, Benzel EC, Vaccaro AR, Sadeghian F, Rahimi-Movaghar V. The impact of data quality assurance and control solutions on the completeness, accuracy, and consistency of data in a national spinal cord injury registry of Iran (NSCIR-IR). Spinal Cord Ser Cases 2021; 7:51. [PMID: 34112766 DOI: 10.1038/s41394-020-00358-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2020] [Revised: 09/29/2020] [Accepted: 10/27/2020] [Indexed: 11/09/2022] Open
Abstract
STUDY DESIGN Descriptive study. OBJECTIVE This study aimed to develop and evaluate a systematic arrangement for improvement and monitoring of data quality of the National Spinal Cord (and Column) Injury Registry of Iran (NSCIR-IR)-a multicenter hospital-based registry. SETTING SCI community in Iran. METHODS Quality assurance and quality control were the primary objectives in improving overall quality of data that were considered in designing a paper-based and computerized case report. To prevent incorrect data entry, we implemented several validation algorithms, including 70 semantic rules, 18 syntactic rules, seven temporal rules, and 13 rules for acceptable value range. Qualified and trained staff members were also employed to review and identify any defect, inaccuracy, or inconsistency in the data to improve data quality. A set of functions were implemented in the software to cross-validate, and feedback on data was provided by reviewers and registrars. RESULTS Socio-demographic data items were 100% complete, except for national ID and education level, which were 97% and 92.3% complete, respectively. Completeness of admission data and emergency medical services data were 100% except for arrival and transfer time (99.4%) and oxygen saturation (48.9%). Evaluation of data received from two centers located in Tehran proved to be 100% accurate following validation by quality reviewers. All data was also found to be 100% consistent. CONCLUSIONS This approach to quality assurance and consistency validation proved to be effective. Our solutions resulted in a significant decrease in the number of missing data.
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Affiliation(s)
- Pegah Derakhshan
- Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Zahra Azadmanjir
- Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran.,Department of Health Information Management, School of Allied Medical Sciences, Tehran University of Medical Sciences, Tehran, Iran
| | - Khatereh Naghdi
- Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Roya Habibi Arejan
- Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahdi Safdarian
- Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Reza Zarei
- Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyed Behzad Jazayeri
- Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahdi Sharif-Alhoseini
- Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Abbas Amirjamshidi
- Department of Neurosurgery, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Zahra Ghodsi
- Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Morteza Faghih Jooybari
- Department of Neurosurgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Zahra Khazaeipour
- Brain and Spinal Injuries Research Center (BASIR), Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Shayan Abdollah Zadegan
- Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Aidin Abedi
- Department of Orthopaedic Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA, 90033, USA
| | - Gerard Oreilly
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, 3800, Australia
| | - Vanessa Noonan
- Rick Hansen Institute, University of British Columbia, Vancouver, BC, V6T 1Z4, Canada
| | - Edward C Benzel
- Department of Neurosurgery, Cleveland Clinic Foundation, Cleveland, OH, 44195, USA
| | - Alexander R Vaccaro
- Department of Orthopaedic Surgery, The Rothman Institute, Thomas Jefferson University, Philadelphia, PA, 19107, USA
| | - Farideh Sadeghian
- Center for Health Related Social and Behavioral Sciences Research, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Vafa Rahimi-Movaghar
- Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran. .,Brain and Spinal Injuries Research Center (BASIR), Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran.
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Arcoraci V, Squadrito F, Altavilla D, Bitto A, Minutoli L, Penna O, Amato A, Bruno R, Tripodi VF, Alibrandi A, Ingrassia PL, Santalucia P, Fodale V. Medical simulation in pharmacology learning and retention: A comparison study with traditional teaching in undergraduate medical students. Pharmacol Res Perspect 2019; 7:e00449. [PMID: 30651989 PMCID: PMC6327107 DOI: 10.1002/prp2.449] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Accepted: 11/12/2018] [Indexed: 12/05/2022] Open
Abstract
The purpose of the study was to determine whether low-high fidelity medical simulation improves learning and long-lasting retention of pharmacology knowledge, compared to lecture alone, in undergraduate medical students. Ninety students, before a 45-minute lecture, were randomized into three groups - sham (S), low (LF), and high fidelity (HF) simulation - to participate in an interactive simulation session. To evaluate immediate and long-lasting retention, a 20-item structured questionnaire on inotropic agents was administered to 90 students before and after a 45-minute lecture, after simulation, and 3 months later. In all groups, the rate of correct answers increased after lecture, while no difference was observed between different groups (P = 0.543). After simulation, students in the HF group provided more correct answers compared to S or LF group (P > 0.001). After 3 months, a significant decrease in the number of correct answers was observed in S (P < 0.001) and LF (P < 0.001) groups, but not in the HF group (P = 0.066). Moreover, HF simulation resulted in an increased number of correct answers compared to the LF (P < 0.001) or S simulation (P < 0.001). These data suggest that advanced medical simulation teaching applied to pharmacology is associated with more effective learning and long-lasting retention compared to lecture alone.
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Affiliation(s)
- Vincenzo Arcoraci
- Department of Clinical and Experimental MedicineUniversity of MessinaMessinaItaly
| | - Francesco Squadrito
- Department of Clinical and Experimental MedicineUniversity of MessinaMessinaItaly
| | - Domenica Altavilla
- Department of Biomedical and Dental Sciences and Morphofunctional ImagingUniversity of MessinaMessinaItaly
| | - Alessandra Bitto
- Department of Clinical and Experimental MedicineUniversity of MessinaMessinaItaly
| | - Letteria Minutoli
- Department of Clinical and Experimental MedicineUniversity of MessinaMessinaItaly
| | - Olivia Penna
- Department of Human Pathology of the Adult and Evolutive Age “Gaetano Barresi”Section of AnesthesiologyUniversity of MessinaMessinaItaly
| | - Antonio Amato
- Department of Human Pathology of the Adult and Evolutive Age “Gaetano Barresi”Section of AnesthesiologyUniversity of MessinaMessinaItaly
| | - Rosario Bruno
- Department of Human Pathology of the Adult and Evolutive Age “Gaetano Barresi”Section of AnesthesiologyUniversity of MessinaMessinaItaly
| | - Vincenzo Francesco Tripodi
- Department of Human Pathology of the Adult and Evolutive Age “Gaetano Barresi”Section of AnesthesiologyUniversity of MessinaMessinaItaly
| | - Angela Alibrandi
- Department of EconomicsUnit of Statistical and Mathematical SciencesUniversity of MessinaMessinaItaly
| | - Pier Luigi Ingrassia
- SIMNOVA Simulation Centre in Medicine and Health ScienceUniversity of Piemonte OrientaleNovaraItaly
| | | | - Vincenzo Fodale
- Department of Human Pathology of the Adult and Evolutive Age “Gaetano Barresi”Section of AnesthesiologyUniversity of MessinaMessinaItaly
- Skill‐Lab for Simulation Based Medical EducationDegree Course In Medicine and SurgeryUniversity of MessinaMessinaItaly
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Genistein Supplementation and Cardiac Function in Postmenopausal Women with Metabolic Syndrome: Results from a Pilot Strain-Echo Study. Nutrients 2017; 9:nu9060584. [PMID: 28590452 PMCID: PMC5490563 DOI: 10.3390/nu9060584] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2017] [Revised: 05/30/2017] [Accepted: 05/31/2017] [Indexed: 12/26/2022] Open
Abstract
Genistein, a soy-derived isoflavone, may improve cardiovascular risk profile in postmenopausal women with metabolic syndrome (MetS), but few literature data on its cardiac effects in humans are available. The aim of this sub-study of a randomized double-blind case-control study was to analyze the effect on cardiac function of one-year genistein dietary supplementation in 22 post-menopausal patients with MetS. Participants received 54 mg/day of genistein (n = 11) or placebo (n = 11) in combination with a Mediterranean-style diet and regular exercise. Left ventricular (LV) systolic function was assessed as the primary endpoint, according to conventional and strain-echocardiography measurements. Also, left atrial (LA) morphofunctional indices were investigated at baseline and at the final visit. Results were expressed as median with interquartile range (IQ). A significant improvement of LV ejection fraction (20.3 (IQ 12.5) vs. −1.67 (IQ 24.8); p = 0.040)), and LA area fractional change (11.1 (IQ 22.6) vs. 2.8 (9.5); p = 0.034)) were observed in genistein patients compared to the controls, following 12 months of treatment. In addition, body surface area indexed LA systolic volume and peak LA longitudinal strain significantly changed from basal to the end of the study in genistein-treated patients. One-year supplementation with 54 mg/day of pure genistein improved both LV ejection fraction and LA remodeling and function in postmenopausal women with MetS.
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Frøen JF, Myhre SL, Frost MJ, Chou D, Mehl G, Say L, Cheng S, Fjeldheim I, Friberg IK, French S, Jani JV, Kaye J, Lewis J, Lunde A, Mørkrid K, Nankabirwa V, Nyanchoka L, Stone H, Venkateswaran M, Wojcieszek AM, Temmerman M, Flenady VJ. eRegistries: Electronic registries for maternal and child health. BMC Pregnancy Childbirth 2016; 16:11. [PMID: 26791790 PMCID: PMC4721069 DOI: 10.1186/s12884-016-0801-7] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2015] [Accepted: 01/07/2016] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND The Global Roadmap for Health Measurement and Accountability sees integrated systems for health information as key to obtaining seamless, sustainable, and secure information exchanges at all levels of health systems. The Global Strategy for Women's, Children's and Adolescent's Health aims to achieve a continuum of quality of care with effective coverage of interventions. The WHO and World Bank recommend that countries focus on intervention coverage to monitor programs and progress for universal health coverage. Electronic health registries - eRegistries - represent integrated systems that secure a triple return on investments: First, effective single data collection for health workers to seamlessly follow individuals along the continuum of care and across disconnected cadres of care providers. Second, real-time public health surveillance and monitoring of intervention coverage, and third, feedback of information to individuals, care providers and the public for transparent accountability. This series on eRegistries presents frameworks and tools to facilitate the development and secure operation of eRegistries for maternal and child health. METHODS In this first paper of the eRegistries Series we have used WHO frameworks and taxonomy to map how eRegistries can support commonly used electronic and mobile applications to alleviate health systems constraints in maternal and child health. A web-based survey of public health officials in 64 low- and middle-income countries, and a systematic search of literature from 2005-2015, aimed to assess country capacities by the current status, quality and use of data in reproductive health registries. RESULTS eRegistries can offer support for the 12 most commonly used electronic and mobile applications for health. Countries are implementing health registries in various forms, the majority in transition from paper-based data collection to electronic systems, but very few have eRegistries that can act as an integrating backbone for health information. More mature country capacity reflected by published health registry based research is emerging in settings reaching regional or national scale, increasingly with electronic solutions. 66 scientific publications were identified based on 32 registry systems in 23 countries over a period of 10 years; this reflects a challenging experience and capacity gap for delivering sustainable high quality registries. CONCLUSIONS Registries are being developed and used in many high burden countries, but their potential benefits are far from realized as few countries have fully transitioned from paper-based health information to integrated electronic backbone systems. Free tools and frameworks exist to facilitate progress in health information for women and children.
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Affiliation(s)
- J Frederik Frøen
- Department of International Public Health, Norwegian Institute of Public Health, Pb 4404 Nydalen, N-0403, Oslo, Norway.
- Centre for Intervention Science in Maternal and Child Health (CISMAC), University of Bergen, Bergen, Norway.
| | - Sonja L Myhre
- Department of International Public Health, Norwegian Institute of Public Health, Pb 4404 Nydalen, N-0403, Oslo, Norway.
| | - Michael J Frost
- Department of International Public Health, Norwegian Institute of Public Health, Pb 4404 Nydalen, N-0403, Oslo, Norway.
- John Snow, Inc., Boston, MA, USA.
| | - Doris Chou
- Department of Reproductive Health and Research, World Health Organization, Geneva, Switzerland.
| | - Garrett Mehl
- Department of Reproductive Health and Research, World Health Organization, Geneva, Switzerland.
| | - Lale Say
- Department of Reproductive Health and Research, World Health Organization, Geneva, Switzerland.
| | - Socheat Cheng
- Department of International Public Health, Norwegian Institute of Public Health, Pb 4404 Nydalen, N-0403, Oslo, Norway.
- Faculty of Medicine, University of Oslo, Oslo, Norway.
| | - Ingvild Fjeldheim
- Department of International Public Health, Norwegian Institute of Public Health, Pb 4404 Nydalen, N-0403, Oslo, Norway.
| | - Ingrid K Friberg
- Department of International Public Health, Norwegian Institute of Public Health, Pb 4404 Nydalen, N-0403, Oslo, Norway.
| | - Steve French
- Department of International Public Health, Norwegian Institute of Public Health, Pb 4404 Nydalen, N-0403, Oslo, Norway.
| | - Jagrati V Jani
- Department of International Public Health, Norwegian Institute of Public Health, Pb 4404 Nydalen, N-0403, Oslo, Norway.
- Centre for Intervention Science in Maternal and Child Health (CISMAC), University of Bergen, Bergen, Norway.
| | - Jane Kaye
- HeLEX - Centre for Health, Law and Emerging Technologies, Nuffield Department of Population Health, University of Oxford, Oxford, UK.
| | - John Lewis
- Health Information System Programme (HISP) Vietnam, Ho Chí Minh, Vietnam.
- Department of Informatics, University of Oslo, Oslo, Norway.
| | - Ane Lunde
- Department of International Public Health, Norwegian Institute of Public Health, Pb 4404 Nydalen, N-0403, Oslo, Norway.
| | - Kjersti Mørkrid
- Department of International Public Health, Norwegian Institute of Public Health, Pb 4404 Nydalen, N-0403, Oslo, Norway.
| | - Victoria Nankabirwa
- Department of International Public Health, Norwegian Institute of Public Health, Pb 4404 Nydalen, N-0403, Oslo, Norway.
- Department of Epidemiology and Biostatics, School of Public Health, College of Health Sciences, Makerere University, Kampala, Uganda.
| | - Linda Nyanchoka
- Department of International Public Health, Norwegian Institute of Public Health, Pb 4404 Nydalen, N-0403, Oslo, Norway.
| | - Hollie Stone
- Department of International Public Health, Norwegian Institute of Public Health, Pb 4404 Nydalen, N-0403, Oslo, Norway.
| | - Mahima Venkateswaran
- Department of International Public Health, Norwegian Institute of Public Health, Pb 4404 Nydalen, N-0403, Oslo, Norway.
- Centre for Intervention Science in Maternal and Child Health (CISMAC), University of Bergen, Bergen, Norway.
| | - Aleena M Wojcieszek
- Mater Research Institute, The University of Queensland, Brisbane, Australia.
- International Stillbirth Alliance, Millburn, NJ, USA.
| | | | - Vicki J Flenady
- Mater Research Institute, The University of Queensland, Brisbane, Australia.
- International Stillbirth Alliance, Millburn, NJ, USA.
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Corrao S, Di Bona D, Di Lorenzo G. Efficacy but not effectiveness of sublingual immunotherapy for grass pollen allergy: Time to avoid waste in health-care expenditure. Eur J Intern Med 2015; 26:561-2. [PMID: 26377975 DOI: 10.1016/j.ejim.2015.08.018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2015] [Revised: 08/28/2015] [Accepted: 08/31/2015] [Indexed: 11/27/2022]
Affiliation(s)
- Salvatore Corrao
- Dipartimento BioMedico di Medicina Interna e Specialistica (Di.Bi.M.I.S), Università degli Studi di Palermo, Italy; Centre of Research for Effectiveness and Appropriateness in Medicine (C.R.E.A.M.), Italy; National Relevance Hospital Trust ARNAS Civico, Di Cristina e Benfratelli, Palermo, Italy.
| | - Danilo Di Bona
- Unità Operativa di Immunoematologia e Medicina Trasfusionale Azienda, Ospedaliera Universitaria Policlinico di Palermo, Italy; Dipartimento di Scienze Statistiche e Matematiche "S. Vianelli", Università degli Studi di Palermo, Italy
| | - Gabriele Di Lorenzo
- Dipartimento BioMedico di Medicina Interna e Specialistica (Di.Bi.M.I.S), Università degli Studi di Palermo, Italy
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Perceptions of physicians about knowledge sharing barriers in Turkish health care system. J Med Syst 2015; 39:42. [PMID: 25732078 DOI: 10.1007/s10916-015-0230-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2014] [Accepted: 02/11/2015] [Indexed: 10/23/2022]
Abstract
This study was based on knowledge sharing barriers about attitudes of physicians in Turkish health care system. The present study aims to determine whether the knowledge sharing barriers about attitudes of physicians vary depending on gender, position, departments at hospitals, and hospital ownership status. This study was planned and conducted on physicians at one public hospital, one university hospital, and one private hospital in Turkey. 209 physicians were reached for data collection. The study was conducted in June-September 2014. The questionnaire (developed by A. Riege, (J. Knowl. Manag. 9(3):18-35, 2005)), five point Likert-type scale including 39 items having the potential of the physicians' knowledge- sharing attitudes and behaviors, was used in the study for data collection. Descriptive statistics, reliability analysis, student t test and ANOVA were used for data analysis. According to results of this study, there was medium level of knowledge sharing barriers within hospitals. In general, physicians had perceptions about the lowest level individual barriers, intermediate level organizational barriers and the highest level technological barriers perceptions, respectively. This study revealed that some knowledge sharing barriers about attitudes of physicians were significantly difference according to hospital ownership status, gender, position and departments. Most evidence medical decisions and evidence based practice depend on experience and knowledge of existing options and knowledge sharing in health care organizations. Physicians are knowledge and information-intensive and principal professional group in health care context.
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Arcoraci V, Santoni L, Ferrara R, Furneri G, Cannata A, Sultana J, Moretti S, Di Luccio A, Tari DU, Pagliaro C, Corrao S, Tari M. Effect of an educational program in primary care: the case of lipid control in cardio-cerebrovascular prevention. Int J Immunopathol Pharmacol 2014; 27:351-63. [PMID: 25280026 DOI: 10.1177/039463201402700305] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Lowering blood cholesterol levels reduces the risk of coronary heart disease. However, the effect of interventions depends on the patients' adherence to treatment. Primary care plays an important role in the detection, treatment and monitoring of disease, therefore different educational programs (EP) have been implemented to improve disease management in general practice. The present study is aimed to assess whether a general practitioner auditing and feedback EP may improve dyslipidaemia management in a primary care setting and to evaluate patients' adherence to prescribed lipid-lowering treatment. The quality of cardiovascular and cerebrovascular disease prevention before and after the implementation of an EP offered to 25 general practitioners (GPs), was evaluated. Clinical and prescription data on patients receiving at least one lipid-lowering treatment was collected. To evaluate the quality of the healthcare service provided, clinical and biochemical outcomes, and drug-utilization, process indicators were set up. Adherence was evaluated before and after the EP as the "Medication Possession Ratio" (MPR). A correlation analysis was carried out to estimate the effect of the MPR in achieving pre-defined clinical end-points. Prescription data for lipid-lowering drugs was collected in a sample of 839 patients. While no differences in the achievement of blood lipid targets were observed, a slight but significant improvement of the MPR was registered after the EP (MPR >0.8=64.2% vs 60.6%, p=0.0426). Moreover, high levels of statin adherence were associated with the achievement of total blood cholesterol target (OR=3.3 for MPR >0.8 vs MPR <0.5, 95% CI:1.7-6.7) or LDL therapeutic goal (OR=3.3 for MPR >0.8 vs MPR <0.5, 95% CI:1.5-7.2). The EP partially improved the defined clinical targets; probably, a more patient-based approach could be more appropriate to achieve the defined target. Further studies are needed to identify how healthcare services can be improved.
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Affiliation(s)
- V Arcoraci
- Department of Clinical and Experimental Medicine and Pharmacology, Pharmacology Unit, University of Messina, Italy
| | - L Santoni
- Pfizer, Department of Outcome Research Roma, Italy
| | - R Ferrara
- Department of Clinical and Experimental Medicine and Pharmacology, Pharmacology Unit, University of Messina, Italy
| | - G Furneri
- Italian National Research Center on Aging (I.N.R.C.A.), Scientific Direction Ancona, Italy
| | - A Cannata
- Department of Clinical and Experimental Medicine and Pharmacology, Pharmacology Unit, University of Messina, Italy
| | - J Sultana
- Department of Clinical and Experimental Medicine and Pharmacology, Pharmacology Unit, University of Messina, Italy
| | - S Moretti
- "Caserta-1" Local Health Unit, Italy
| | | | - D U Tari
- "Caserta-1" Local Health Unit, Italy
| | | | - S Corrao
- Di.Bi.MIS, University of Palermo, Internal Medicine Division ARNAS Civico, Palermo, Italy
| | - M Tari
- "Caserta-1" Local Health Unit, Italy
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Ndabarora E, Chipps JA, Uys L. Systematic review of health data quality management and best practices at community and district levels in LMIC. INFORMATION DEVELOPMENT 2013. [DOI: 10.1177/0266666913477430] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Research findings have reported lack of reliable health data and poor management for district health information systems in low and middle-income countries (LMIC). This paper aims to review the literature on problems with health data quality management and health information evidences and evidences of best practices and use at community and district levels in LMIC, with a view to making recommendations for future research. Research citations, conference proceedings and diseases surveillance reports from 2000–2011 were accessed in PubMed, Medline, LISTA (EBSCO), CINAHL, Cochrane, and Google. Relevant studies were selected, the methodologies critiqued and synthesized. The researchers accessed 1383, and 38 were reviewed by three reviewers. Poor quality health data, low level of health information use, and poor management of health information systems were found. These findings hinder evidence-based decisions based and planning at community and district levels in LMIC. Though poor practices were found, improved health care services delivery with improved health data efficiency was found to be possible.
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Mutale W, Chintu N, Amoroso C, Awoonor-Williams K, Phillips J, Baynes C, Michel C, Taylor A, Sherr K. Improving health information systems for decision making across five sub-Saharan African countries: Implementation strategies from the African Health Initiative. BMC Health Serv Res 2013; 13 Suppl 2:S9. [PMID: 23819699 PMCID: PMC3668230 DOI: 10.1186/1472-6963-13-s2-s9;13] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023] Open
Abstract
BACKGROUND Weak health information systems (HIS) are a critical challenge to reaching the health-related Millennium Development Goals because health systems performance cannot be adequately assessed or monitored where HIS data are incomplete, inaccurate, or untimely. The Population Health Implementation and Training (PHIT) Partnerships were established in five sub-Saharan African countries (Ghana, Mozambique, Rwanda, Tanzania, and Zambia) to catalyze advances in strengthening district health systems. Interventions were tailored to the setting in which activities were planned. COMPARISONS ACROSS STRATEGIES All five PHIT Partnerships share a common feature in their goal of enhancing HIS and linking data with improved decision-making, specific strategies varied. Mozambique, Ghana, and Tanzania all focus on improving the quality and use of the existing Ministry of Health HIS, while the Zambia and Rwanda partnerships have introduced new information and communication technology systems or tools. All partnerships have adopted a flexible, iterative approach in designing and refining the development of new tools and approaches for HIS enhancement (such as routine data quality audits and automated troubleshooting), as well as improving decision making through timely feedback on health system performance (such as through summary data dashboards or routine data review meetings). The most striking differences between partnership approaches can be found in the level of emphasis of data collection (patient versus health facility), and consequently the level of decision making enhancement (community, facility, district, or provincial leadership). DISCUSSION Design differences across PHIT Partnerships reflect differing theories of change, particularly regarding what information is needed, who will use the information to affect change, and how this change is expected to manifest. The iterative process of data use to monitor and assess the health system has been heavily communication dependent, with challenges due to poor feedback loops. Implementation to date has highlighted the importance of engaging frontline staff and managers in improving data collection and its use for informing system improvement. Through rigorous process and impact evaluation, the experience of the PHIT teams hope to contribute to the evidence base in the areas of HIS strengthening, linking HIS with decision making, and its impact on measures of health system outputs and impact.
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Affiliation(s)
- Wilbroad Mutale
- Centre for Infectious Disease Research in Zambia, Zambia
- School of Medicine, University of Zambia, Zambia
| | | | | | | | - James Phillips
- Heilbrunn Department of Population and Family Health, Mailman School of Public Health, Columbia University, NY, USA
| | - Colin Baynes
- Heilbrunn Department of Population and Family Health, Mailman School of Public Health, Columbia University, NY, USA
- Ifakara Health Institute , Mikocheni, Dar-es-Salaam, Tanzania
| | - Cathy Michel
- Health Alliance International, Direcçao Provincial de Saúde, Beira, Sofala, Mozambique
| | - Angela Taylor
- Centre for Infectious Disease Research in Zambia, Zambia
| | - Kenneth Sherr
- Department of Global Health, University of Washington, Seattle, USA
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Mutale W, Chintu N, Amoroso C, Awoonor-Williams K, Phillips J, Baynes C, Michel C, Taylor A, Sherr K. Improving health information systems for decision making across five sub-Saharan African countries: Implementation strategies from the African Health Initiative. BMC Health Serv Res 2013; 13 Suppl 2:S9. [PMID: 23819699 PMCID: PMC3668230 DOI: 10.1186/1472-6963-13-s2-s9] [Citation(s) in RCA: 148] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Weak health information systems (HIS) are a critical challenge to reaching the health-related Millennium Development Goals because health systems performance cannot be adequately assessed or monitored where HIS data are incomplete, inaccurate, or untimely. The Population Health Implementation and Training (PHIT) Partnerships were established in five sub-Saharan African countries (Ghana, Mozambique, Rwanda, Tanzania, and Zambia) to catalyze advances in strengthening district health systems. Interventions were tailored to the setting in which activities were planned. COMPARISONS ACROSS STRATEGIES All five PHIT Partnerships share a common feature in their goal of enhancing HIS and linking data with improved decision-making, specific strategies varied. Mozambique, Ghana, and Tanzania all focus on improving the quality and use of the existing Ministry of Health HIS, while the Zambia and Rwanda partnerships have introduced new information and communication technology systems or tools. All partnerships have adopted a flexible, iterative approach in designing and refining the development of new tools and approaches for HIS enhancement (such as routine data quality audits and automated troubleshooting), as well as improving decision making through timely feedback on health system performance (such as through summary data dashboards or routine data review meetings). The most striking differences between partnership approaches can be found in the level of emphasis of data collection (patient versus health facility), and consequently the level of decision making enhancement (community, facility, district, or provincial leadership). DISCUSSION Design differences across PHIT Partnerships reflect differing theories of change, particularly regarding what information is needed, who will use the information to affect change, and how this change is expected to manifest. The iterative process of data use to monitor and assess the health system has been heavily communication dependent, with challenges due to poor feedback loops. Implementation to date has highlighted the importance of engaging frontline staff and managers in improving data collection and its use for informing system improvement. Through rigorous process and impact evaluation, the experience of the PHIT teams hope to contribute to the evidence base in the areas of HIS strengthening, linking HIS with decision making, and its impact on measures of health system outputs and impact.
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Integration of evidence-based knowledge management in microsystems: a tele-ICU experience. Crit Care Nurs Q 2013; 35:335-40. [PMID: 22948366 DOI: 10.1097/cnq.0b013e318266bfd1] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
The Institute of Medicine's proposed 6 aims to improve health care are timely, safe, effective, efficient, equitable, and patient-centered care. Unfortunately, it also asserts that improvements in these 6 dimensions cannot be achieved within the existing framework of care systems. These systems are based on unrealistic expectations on human cognition and vigilance, and demonstrate a lack of dependence on computerized systems to support care processes and put information at the point of use. Knowledge-based care and evidence-based clinical decision-making need to replace the unscientific care that is being delivered in health care. Building care practices on evidence within an information technology platform is needed to support sound clinical decision-making and to influence organizational adoption of evidence-based practice in health care. Despite medical advances and evidence-based recommendations for treatment of severe sepsis, it remains a significant cause of mortality and morbidity in the world. It is a complex disease state that has proven difficult to define, diagnose, and treat. Supporting bedside teams with real-time knowledge and expertise to target early identification of severe sepsis and compliance to Surviving Sepsis Campaign, evidence-based practice bundles are important to improving outcomes. Using a centralized, remote team of expert nurses and an open-source software application to advance clinical decision-making and execution of the severe sepsis bundle will be examined.
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Abstract
In 2001, the Institute of Medicine report Crossing the Quality Chasm and the National Committee on Vital and Health Statistics report Information for Health were released, and they provided the context for the development of information systems used to support health-supporting processes. Both had as their goals, implicit or explicit, to ensure the right data are provided to the right person at the right time, which is one definition of "data liquidity." This concept has had some traction in recent years as a shorthand way to express a system property for health information technology, but there is not a well-defined characterization of what properties of a system or of its components give it better or worse data liquidity. This article looks at some recent work that help to identify those properties and perhaps can help to ground the concept with metrics that are assessable.
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Affiliation(s)
- Paul K Courtney
- Clinical Research Directorate/CMRP, SAIC-Frederick, Inc, NCI-Frederick, MD, USA.
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Corrao S, Calvo L, Licata G. The new criteria for classification of rheumatoid arthritis: what we need to know for clinical practice. Eur J Intern Med 2011; 22:217-9. [PMID: 21570636 DOI: 10.1016/j.ejim.2010.12.018] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2010] [Revised: 12/19/2010] [Accepted: 12/22/2010] [Indexed: 11/24/2022]
Abstract
The new criteria for classification of Rheumatoid Arthritis have been recently released. They incorporate the anti-Citrullinated Protein antibody testing and the other classic criteria in a score system (the diagnosis of definite rheumatoid arthritis is made by a total score ≥6). These criteria try to meet the pressing needs to gain sensitivity in early disease. Symptoms, elevated acute-phase response, serologic abnormality, joint involvement were all considered for scoring after confirming the presence of synovitis in at least 1 joint in the absence of an alternative diagnosis that better explains the synovitis. However, no sensitivity and specificity has been showed. Moreover, Area Under Curve of the Receiver Operating Characteristic curves (a measure of performance of the test) was not optimal in almost two of the three studied cohorts. On the contrary, the old criteria of the American College of Rheumatology had been tested to calculate sensitivity and specificity. Moreover, sensitivity and specificity of anti-citrullinated peptide auto-antibodies are available for clinical reasoning based on pre-test and post-test probabilities of the disease. The use of likelihood ratios applied to both the old criteria and anti-citrullinated autoantibodies could help clinicians to effectively manage early arthritis patients implementing Bayesian reasoning. Here, we tried to explain the methodology applied to the body of knowledge currently available about rheumatoid arthritis for diagnostic decision-making based on the Bayesian approach.
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Affiliation(s)
- Salvatore Corrao
- Dipartimento Biomedico di Medicina Interna e Specialistica, University of Palermo, Italy.
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