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Wang K, Tan X, Nan S, Sang L, Chen H, Duan H. OLR-Net: Object Label Retrieval Network for principal diagnosis extraction. Comput Biol Med 2024; 182:109130. [PMID: 39288555 DOI: 10.1016/j.compbiomed.2024.109130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2024] [Revised: 08/26/2024] [Accepted: 09/06/2024] [Indexed: 09/19/2024]
Abstract
BACKGROUND Extracting principal diagnosis from patient discharge summaries is an essential task for the meaningful use of medical data. The extraction process, usually by medical staff, is laborious and time-consuming. Although automatic models have been proposed to retrieve principal diagnoses from medical records, many rare diagnoses and a small amount of training data per rare diagnosis provide significant statistical and computational challenges. OBJECTIVE In this study, we aimed to extract principal diagnoses with limited available data. METHODS We proposed the OLR-Net, Object Label Retrieval Network, to extract principal diagnoses for discharge summaries. Our approach included semantic extraction, label localization, label retrieval, and recommendation. The semantic information of discharge summaries was mapped into the diagnoses set. Then, one-dimensional convolutional neural networks slid into the bottom-up region for diagnosis localization to enrich rare diagnoses. Finally, OLR-Net detected the principal diagnosis in the localized region. The evaluation metrics focus on the hit ratio, mean reciprocal rank, and the area under the receiver operating characteristic curve (AUROC). RESULTS 12,788 desensitized discharge summary records were collected from the oncology department at Hainan Hospital of Chinese People's Liberation Army General Hospital. We designed five distinct settings based on the number of training data per diagnosis: the full dataset, the top-50 dataset, the few-shot dataset, the one-shot dataset, and the zero-shot dataset. The performance of our model had the highest HR@5 of 0.8778 and macro-AUROC of 0.9851. In the limited available (few-shot and one-shot) dataset, the macro-AUROC were 0.9833 and 0.9485, respectively. CONCLUSIONS OLR-Net has great potential for extracting principal diagnosis with limited available data through label localization and retrieval.
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Affiliation(s)
- Kai Wang
- Key Laboratory of Biomedical Engineering of Hainan Province, School of Biomedical Engineering, Hainan University, Haikou 570228, China; School of Information and Communication Engineering, Hainan University, Haikou 570228, China
| | - Xin Tan
- Key Laboratory of Biomedical Engineering of Hainan Province, School of Biomedical Engineering, Hainan University, Haikou 570228, China; College of Biomedical Engineering and Instrumental Science, Zhejiang University, Hangzhou 310027, China
| | - Shan Nan
- Key Laboratory of Biomedical Engineering of Hainan Province, School of Biomedical Engineering, Hainan University, Haikou 570228, China.
| | - Lei Sang
- Hainan Hospital of Chinese People's Liberation Army General Hospital, Sanya 572013, China
| | - Han Chen
- Hainan Hospital of Chinese People's Liberation Army General Hospital, Sanya 572013, China
| | - Huilong Duan
- Key Laboratory of Biomedical Engineering of Hainan Province, School of Biomedical Engineering, Hainan University, Haikou 570228, China; College of Biomedical Engineering and Instrumental Science, Zhejiang University, Hangzhou 310027, China
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Andersen TH, Marcussen TM, Nørgaard O. Information needs for GPs on type 2 diabetes in Western countries: a systematic review. Br J Gen Pract 2024:BJGP.2023.0531. [PMID: 38429111 PMCID: PMC11388096 DOI: 10.3399/bjgp.2023.0531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Accepted: 02/26/2024] [Indexed: 03/03/2024] Open
Abstract
BACKGROUND Most people with type 2 diabetes receive treatment in primary care by GPs who are not specialised in diabetes. Thus, it is important to uncover the most essential information needs regarding type 2 diabetes in general practice. AIM To identify information needs related to type 2 diabetes for GPs. DESIGN AND SETTING Systematic review focused on literature relating to Western countries. METHOD MEDLINE, Embase, PsycInfo and CINAHL were searched from inception to January 2024. Two researchers conducted the selection process, and citation searches were performed to identify any relevant articles missed by the database search. Quality appraisal was conducted with the Mixed Methods Appraisal Tool. Meaning units were coded individually, grouped into categories, and then studies were summarised within the context of these categories using narrative synthesis. An evidence map was created to highlight research gaps. RESULTS Thirty-nine included studies revealed eight main categories and 36 subcategories of information needs. Categories were organised into a comprehensive hierarchical model of information needs, suggesting 'Knowledge of guidelines' and 'Reasons for referral' as general information needs alongside more specific needs on 'Medication', 'Management', 'Complications', 'Diagnosis', 'Risk factors', and 'Screening for diabetes'. The evidence map provides readers with the opportunity to explore the characteristics of the included studies in detail. CONCLUSION This systematic review provides GPs, policymakers, and researchers with a hierarchical model of information and educational needs for GPs, and an evidence map showing gaps in the current literature. Information needs about clinical guidelines and reasons for referral to specialised care overlapped with needs for more specific information.
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Affiliation(s)
- Tue Helms Andersen
- Danish Diabetes Knowledge Center, Copenhagen University Hospital - Steno Diabetes Center Copenhagen, Herlev, Denmark
| | - Thomas Møller Marcussen
- Danish Diabetes Knowledge Center, Copenhagen University Hospital - Steno Diabetes Center Copenhagen, Herlev, Denmark
| | - Ole Nørgaard
- Danish Diabetes Knowledge Center, Copenhagen University Hospital - Steno Diabetes Center Copenhagen, Herlev, Denmark
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Cerejo C. The untold emotional toll of navigating the health system: the journey of patients in/from India, living with serious and/or chronic conditions. Curr Med Res Opin 2024; 40:1605-1613. [PMID: 39078234 DOI: 10.1080/03007995.2024.2383732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2024] [Revised: 07/12/2024] [Accepted: 07/18/2024] [Indexed: 07/31/2024]
Abstract
Patient journey mapping, a novel method to visualize all the interactions a patient might have with the health system, is increasingly being adopted by the healthcare industry to identify challenges patients face, with the goal of improving health outcomes. However, patient journey maps are often used internally within pharma companies and are not published widely. Here, I conducted in-depth interviews with eight Indian patients/caregivers dealing with chronic and/or serious conditions; seven of the interviewees were living in India and spoke entirely from the perspective of the Indian health system, whereas one spoke from his experience of living in India, Ireland, and the UK. Using insights from these interviews, drawing on my own experience as a patient living with a rare disease and multiple comorbidities, and seeking feedback from several international patient advocates and industry professionals, I constructed a detailed map visualizing the collective journey of patients with serious/chronic conditions. Apart from showing the different stages in the patient journey, the map visualizes the associated stress levels, pain points (issues leading to a negative experience), emotions, and information-seeking behavior. One key insight that emerges is that along with a range of highly variable emotions patients experience, stress is a consistent factor throughout the patient journey. In many cases, the stress is caused or exacerbated by factors that can be avoided, such as long wait times, procedural hassles, inadequate or inaccurate information, and lack of empathy in interactions with healthcare professionals. The frustrations patients experience stem from a mix of underlying practical/tangible and emotional/aspirational needs. I have discussed these needs at length and provided suggestions for changes that could be implemented in the health system to meet these needs better. While my analysis presented here is generally framed from the context of the Indian health system, and some points discussed might have nuances in other health systems, the themes and insights provided are relevant to all patients and their journey, anywhere in the world. Pharmaceutical industry professionals, healthcare providers, and policymakers may benefit from these insights and may apply them to make strategic decisions and changes in their approach, with the goal of improving patient experience and health outcomes globally.
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Affiliation(s)
- Clarinda Cerejo
- The Sumaira Foundation, Boston, MA, USA
- Global Patient Advocacy Coalition, New York City, NY, USA
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Odouard IC, Ballreich J, Lee B, Socal MP. Clinical Evidence Supporting FDA Approval of Gene and RNA Therapies for Rare Inherited Conditions. Paediatr Drugs 2024:10.1007/s40272-024-00645-7. [PMID: 39102172 DOI: 10.1007/s40272-024-00645-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/15/2024] [Indexed: 08/06/2024]
Abstract
BACKGROUND Gene and RNA therapies have potential to transform the treatment of rare inherited diseases, but there are concerns about the evidence supporting their use and high costs. OBJECTIVE We analyze the evidence supporting Food and Drug Administration (FDA) approval of gene and RNA therapies for rare inherited diseases and discuss implications for clinical practice and policy. METHODS We conducted a qualitative analysis of FDA documents outlining the basis of approval for gene and RNA therapies approved for rare inherited diseases between 2016 and 2023. For each drug, we gathered five characteristics of the evidence supporting FDA approval (no phase 3 trial, nonrandomized, no clinical endpoint, lack of demonstrated benefit, and significant protocol deviation) and four characteristics of the FDA approval process (prior rejection or complete response, negative committee vote, discrepancy between label and trial population, and boxed warning). The main outcome was the number of drugs with each characteristic. RESULTS Between 2016 and 2023, 19 gene and RNA therapies received FDA approval to treat rare inherited diseases. The most common limitations in the evidence supporting approval of these drugs were nonrandomized studies (8/19, 42%), no clinical endpoint (7/19, 37%), lack of demonstrated benefit or inconsistent results (4/19, 21%), and no phase 3 trial (4/19, 21%). Half (3/6) of accelerated approvals and 57% (5/9) of drugs with breakthrough designation had nonrandomized trials, and gene therapies with one-time dosing were overrepresented (5/7, 71%) among the drugs with nonrandomized trials. Five of six accelerated approvals (83%) and five of nine pediatric drugs (56%), most of which were indicated for Duchenne muscular dystrophy, had no clinical endpoint. Four of nine (44%) pediatric drugs and four of six (67%) accelerated approvals failed to demonstrate benefit compared with none of the nonpediatric drugs and none of the traditional approvals. Five drugs, which all had different indications and represented a mix of RNA and gene therapies, did not have any of these evidence characteristics. Among drugs that received prior rejections or negative committee opinions, all four had nonrandomized trials and lacked a clinical endpoint, and 75% (3/4) lacked demonstrated benefit. Five of nine (56%) pediatric drugs were indicated for broader age groups according to the drug label compared with the trial populations. Of the three drugs with boxed warnings, two had pediatric indications and nonrandomized studies, and one had no phase 3 trial. CONCLUSIONS Issues related to trial design, outcome, and data integrity in the evidence supporting FDA approval of rare inherited disease gene and RNA therapies raise questions about whether this evidence is adequate to inform prescribing decisions. Gene and RNA therapies with accelerated approval and pediatric indications were overrepresented among drugs lacking clinical endpoints or demonstrated benefit and should be the focus of efforts to reduce uncertainty in the evidence.
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Affiliation(s)
- Ilina C Odouard
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, 624 N. Broadway, Hampton House 301, Baltimore, MD, 21205, USA
| | - Jeromie Ballreich
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, 624 N. Broadway, Hampton House 301, Baltimore, MD, 21205, USA
| | - Branden Lee
- Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Mariana P Socal
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, 624 N. Broadway, Hampton House 301, Baltimore, MD, 21205, USA.
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Alele FO, Albert FA, Anderson E, Seidu AA, Mason H, Heggarty P, Hollins A, Sen Gupta T, McArthur L, Hays RB, Malau-Aduli BS. The perceived relevance, utility and retention of basic sciences in general practice. BMC MEDICAL EDUCATION 2024; 24:809. [PMID: 39075437 PMCID: PMC11285199 DOI: 10.1186/s12909-024-05750-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/10/2024] [Accepted: 07/08/2024] [Indexed: 07/31/2024]
Abstract
BACKGROUND Basic sciences are crucial for clinical medicine, yet studies focusing on their perceived utility among general practitioners (GPs) are sparse. Considering the broad scope of GPs' practice, an in-depth understanding of basic sciences is fundamental for making informed clinical decisions. This study evaluated GP registrars' retention and perceptions of the utility of basic sciences in clinical practice. METHODS Using sequential explanatory mixed methods study design, knowledge retention was assessed by a multiple-choice question (MCQ) examination followed by interviews on the perception of the relevance and utility of basic sciences among GP registrars at James Cook University's (JCU) General Practice Training (GPT) program. Descriptive and inferential statistical analyses were conducted on the MCQ exam data, while thematic analysis was employed for the qualitative interview data. RESULTS Sixty-one GP registrars participated in the MCQ exam, while 11 of them were involved in the interviews. The highest mean score was obtained in biochemistry (75.1 ± 2.23) while the lowest mean score was in anatomy (56.07 ± 3.16). Key performance predictors included the formative clinical examination scores (β = 0.83, 95% CI: 0.45 to 1.2, p < 0.001) and gender (β = -9.7, 95% CI: -17 to -2.3, p = 0.011). The qualitative data analysis revealed five themes, including the backbone of clinical medicine, varying utility over time and by specialty, clinical synthesis integrates encapsulated knowledge, professional pressures hinder revisitation of knowledge and knowledge renewal enhances updates. CONCLUSION Basic sciences were considered relevant in clinical practice. Development of continuing professional development (CPDs) sessions and clinically relevant online resources were measures proposed to enhance the retention of knowledge. Future research could focus on innovative educational strategies for GPs.
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Affiliation(s)
- Faith O Alele
- College of Medicine and Dentistry, James Cook University, Townsville, QLD, 4811, Australia
- School of Health, University of the Sunshine Coast, Sunshine Coast, QLD, 4556, Australia
| | - Francis A Albert
- College of Medicine and Dentistry, James Cook University, Townsville, QLD, 4811, Australia
| | - Emma Anderson
- College of Medicine and Dentistry, James Cook University, Townsville, QLD, 4811, Australia
| | - Abdul-Aziz Seidu
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, QLD, 4811, Australia
| | - Hannah Mason
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, QLD, 4811, Australia
| | - Paula Heggarty
- College of Medicine and Dentistry, James Cook University, Townsville, QLD, 4811, Australia
| | - Aaron Hollins
- College of Medicine and Dentistry, James Cook University, Townsville, QLD, 4811, Australia
| | - Tarun Sen Gupta
- College of Medicine and Dentistry, James Cook University, Townsville, QLD, 4811, Australia
| | - Lawrie McArthur
- Discipline of General Practice, The University of Adelaide, Adelaide, SA, 5005, Australia
- Adelaide Rural Clinical School, University of Adelaide, Adelaide, SA, 5606, Australia
| | - Richard B Hays
- College of Medicine and Dentistry, James Cook University, Townsville, QLD, 4811, Australia
| | - Bunmi S Malau-Aduli
- College of Medicine and Dentistry, James Cook University, Townsville, QLD, 4811, Australia.
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, The University of Newcastle, Callaghan, NSW, 2308, Australia.
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Lee MM, Tang WE, Smith HE, Tudor Car L. Information-seeking behaviour of primary care clinicians in Singapore at the point-of-care: A qualitative study. Health Info Libr J 2024. [PMID: 38804103 DOI: 10.1111/hir.12535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 04/16/2024] [Accepted: 04/22/2024] [Indexed: 05/29/2024]
Abstract
BACKGROUND Clinicians' information-seeking behaviours impact patient care quality. Earlier studies indicated that barriers to accessing information deter clinicians from seeking answers to clinical questions. OBJECTIVES To explore primary care clinicians' information-seeking behaviour at point-of-care, focusing on when and how they seek answers to clinical questions. METHODS Semi-structured interviews were conducted with 45 clinicians after clinical sessions to investigate their information-seeking habits. Follow-up interviews were conducted after a week for those intending to address unanswered queries. RESULTS Two thirds of clinicians encountered questions during care, with nearly three quarters resolving them during the session. Colleagues, guidelines and online platforms were common information sources, with smartphones being used to access Google, WhatsApp or UpToDate®. Facilitators included reliable sources and the drive to confirm knowledge, while barriers included ineffective search methods and high workload. Despite challenges, most clinicians expressed satisfaction with their information-seeking process. DISCUSSION The findings underscore the increasing use of smartphones for accessing clinical information among Singaporean primary care clinicians and suggest the need for tailored training programmes and guidelines to optimise information-seeking practices. CONCLUSION Insights from this study can inform the development of training programmes and guidelines aimed at improving information-seeking practices among primary care clinicians, potentially enhancing patient care quality.
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Affiliation(s)
- Mauricette Moling Lee
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
- Health and Social Sciences, Singapore Institute of Technology, Singapore, Singapore
| | - Wern Ee Tang
- Clinical Research Unit, National Healthcare Group Polyclinics (NHGP), Singapore, Singapore
| | - Helen Elizabeth Smith
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Lorainne Tudor Car
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
- Department of Primary Care and Public Health, School of Public Health, Imperial College London, London, UK
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Lee MM, Tang WE, Smith HE, Tudor Car L. Identifying primary care clinicians' preferences for, barriers to, and facilitators of information-seeking in clinical practice in Singapore: a qualitative study. BMC PRIMARY CARE 2024; 25:172. [PMID: 38762445 PMCID: PMC11102200 DOI: 10.1186/s12875-024-02429-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 05/12/2024] [Indexed: 05/20/2024]
Abstract
BACKGROUND The growth of medical knowledge and patient care complexity calls for improved clinician access to evidence-based resources. This study aimed to explore the primary care clinicians' preferences for, barriers to, and facilitators of information-seeking in clinical practice in Singapore. METHODS A convenience sample of ten doctors and ten nurses was recruited. We conducted semi-structured face-to-face in-depth interviews. The interviews were recorded, transcribed verbatim, and analysed using thematic content analysis. RESULTS Of the 20 participants, eight doctors and ten nurses worked at government-funded polyclinics and two doctors worked in private practice. Most clinicians sought clinical information daily at the point-of-care. The most searched-for information by clinicians in practice was less common conditions. Clinicians preferred evidence-based resources such as clinical practice guidelines and UpToDate®. Clinical practice guidelines were mostly used when they were updated or based on memory. Clinicians also commonly sought answers from their peers. Furthermore, clinicians frequently use smartphones to access the Google search engine and UpToDate® app. The barriers to accessing clinical information included the lack of time, internet surfing separation of work computers, limited search functions in the organisation's server, and limited access to medical literature databases. The facilitators of accessing clinical information included convenience, easy access, and trustworthiness of information sources. CONCLUSION Most primary care clinicians in our study sought clinical information at the point-of-care daily and reported increasing use of smartphones for information-seeking. Future research focusing on interventions to improve access to credible clinical information for primary care clinicians at the point-of-care is recommended. TRIAL REGISTRATION This study has been reviewed by NHG Domain Specific Review Board (NHG DSRB) (the central ethics committee) for ethics approval. NHG DSRB Reference Number: 2018/01355 (31/07/2019).
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Affiliation(s)
- Mauricette Moling Lee
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Novena Campus Clinical Sciences Building 11 Mandalay Road, Singapore, 308232, Singapore
- Singapore Institute of Technology, 10 Dover Drive, Singapore, 138683, Singapore
| | - Wern Ee Tang
- Clinical Research Unit, National Health Group Polyclinics (HQ), 3 Fusionopolis Link, Nexus @ One-North, Singapore, 138543, Singapore
| | - Helen Elizabeth Smith
- Family Medicine and Primary Care, Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Novena Campus Clinical Sciences, Building 11 Mandalay Road, Singapore, 308232, Singapore
| | - Lorainne Tudor Car
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Novena Campus Clinical Sciences Building 11 Mandalay Road, Singapore, 308232, Singapore.
- Department of Primary Care and Public Health, School of Public Health, Imperial College London, London, UK.
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Daei A, Soleymani MR, Zargham-Boroujeni A, Kelishadi R, Ashrafi-Rizi H. Modelling of physicians' clinical information-seeking behaviour in Iran: a grounded theory study. BMJ Open 2024; 14:e080602. [PMID: 38626973 PMCID: PMC11029460 DOI: 10.1136/bmjopen-2023-080602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Accepted: 04/03/2024] [Indexed: 04/19/2024] Open
Abstract
OBJECTIVES Exploring clinical information-seeking behaviour (CISB) and its associated factors contributes to its theoretical advancement and offers a valuable framework for addressing physicians' information needs. This study delved into the dimensions, interactions, strategies and determinants of CISB among physicians at the point of care. DESIGN A grounded theory study was developed based on Strauss and Corbin's approach. Data were collected by semistructured interviews and then analysed through open, axial and selective coding. SETTING The study was conducted at academic centres affiliated with Isfahan University of Medical Sciences. PARTICIPANTS This investigation involved recruiting 21 specialists and subspecialists from the academic centres. RESULTS The findings revealed that physicians' CISB encompassed multiple dimensions when addressing clinical inquiries. Seven principal themes emerged from the analysis: 'clinical information needs', 'clinical question characteristics', 'clinical information resources', 'information usability', 'factors influencing information seeking', 'action/interaction encountering clinical questions' and 'consequences of CISB'. The core category identified in this study was 'focused attention'. CONCLUSIONS The theoretical explanation demonstrated that the CISB process was interactive and dynamic. Various stimuli, including causal, contextual and intervening conditions, guide physicians in adopting information-seeking strategies and focusing on resolving clinical challenges. However, insufficient stimuli may hinder physicians' engagement in CISB. Understanding CISB helps managers, policy-makers, clinical librarians and information system designers optimally implement several interventions, such as suitable training methods, reviewing monitoring and evaluating information systems, improving clinical decision support systems, electronic medical records and electronic health records, as well as monitoring and evaluating these systems. Such measures facilitate focused attention on clinical issues and promote CISB among physicians.
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Affiliation(s)
- Azra Daei
- Department of Medical Library and Information Science, School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mohammad Reza Soleymani
- Health Information Technology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ali Zargham-Boroujeni
- Nursing and Midwifery Care Research Center, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Roya Kelishadi
- Department of Pediatrics, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-communicable Diseases, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Hasan Ashrafi-Rizi
- Health Information Technology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
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Beverly EA, Koopman-Gonzalez S, Wright J, Dungan K, Pallerla H, Gubitosi-Klug R, Baughman K, Konstan MW, Bolen SD. Assessing Priorities in a Statewide Cardiovascular and Diabetes Health Collaborative Based on the Results of a Needs Assessment: Cross-Sectional Survey Study. JMIR Form Res 2024; 8:e55285. [PMID: 38607661 PMCID: PMC11053386 DOI: 10.2196/55285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Revised: 02/14/2024] [Accepted: 02/23/2024] [Indexed: 04/13/2024] Open
Abstract
BACKGROUND The Ohio Cardiovascular and Diabetes Health Collaborative (Cardi-OH) unites general and subspecialty medical staff at the 7 medical schools in Ohio with community and public health partnerships to improve cardiovascular and diabetes health outcomes and eliminate disparities in Ohio's Medicaid population. Although statewide collaboratives exist to address health improvements, few deploy needs assessments to inform their work. OBJECTIVE Cardi-OH conducts an annual needs assessment to identify high-priority clinical topics, screening practices, policy changes for home monitoring devices and referrals, and preferences for the dissemination and implementation of evidence-based best practices. The results of the statewide needs assessment could also be used by others interested in disseminating best practices to primary care teams. METHODS A cross-sectional survey was distributed electronically via REDCap (Research Electronic Data Capture; Vanderbilt University) to both Cardi-OH grant-funded and non-grant-funded members (ie, people who have engaged with Cardi-OH but are not funded by the grant). RESULTS In total, 88% (103/117) of Cardi-OH grant-funded members and 8.14% (98/1204) of non-grant-funded members completed the needs assessment survey. Of these, 51.5% (53/103) of Cardi-OH grant-funded members and 47% (46/98) of non-grant-funded members provided direct clinical care. The top cardiovascular medicine and diabetes clinical topics for Cardi-OH grant-funded members (clinical and nonclinical) were lifestyle prescriptions (50/103, 48.5%), atypical diabetes (38/103, 36.9%), COVID-19 and cardiovascular disease (CVD; 38/103, 36.9%), and mental health and CVD (38/103, 36.9%). For non-grant-funded members, the top topics were lifestyle prescriptions (53/98, 54%), mental health and CVD (39/98, 40%), alcohol and CVD (27/98, 28%), and cardiovascular complications (27/98, 28%). Regarding social determinants of health, Cardi-OH grant-funded members prioritized 3 topics: weight bias and stigma (44/103, 42.7%), family-focused interventions (40/103, 38.8%), and adverse childhood events (37/103, 35.9%). Non-grant-funded members' choices were family-focused interventions (51/98, 52%), implicit bias (43/98, 44%), and adverse childhood events (39/98, 40%). Assessment of other risk factors for CVD and diabetes across grant- and non-grant-funded members revealed screening for social determinants of health in approximately 50% of patients in each practice, whereas some frequency of depression and substance abuse screening occurred in 80% to 90% of the patients. Access to best practice home monitoring devices was challenging, with 30% (16/53) and 41% (19/46) of clinical grant-funded and non-grant-funded members reporting challenges in obtaining home blood pressure monitoring devices and 68% (36/53) and 43% (20/46) reporting challenges with continuous glucose monitors. CONCLUSIONS Cardi-OH grant- and non-grant-funded members shared the following high-priority topics: lifestyle prescriptions, CVD and mental health, family-focused interventions, alcohol and CVD, and adverse childhood experiences. Identifying high-priority educational topics and preferred delivery modalities for evidence-based materials is essential for ensuring that the dissemination of resources is practical and useful for providers.
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Affiliation(s)
- Elizabeth A Beverly
- Department of Primary Care, Ohio University Heritage College of Osteopathic Medicine, Athens, OH, United States
| | | | - Jackson Wright
- Department of Medicine, Case Western Reserve University, Cleveland, OH, United States
| | - Kathleen Dungan
- Department of Medicine, Ohio State University College of Medicine, Columbus, OH, United States
| | - Harini Pallerla
- Department of Family and Community Medicine, University of Cincinnati College of Medicine, Cincinnati, OH, United States
| | - Rose Gubitosi-Klug
- Department of Medicine, Case Western Reserve University, Cleveland, OH, United States
| | - Kristin Baughman
- Department of Family and Community Medicine, Northeast Ohio Medical University, Rootstown, OH, United States
| | - Michael W Konstan
- Department of Medicine, Case Western Reserve University, Cleveland, OH, United States
| | - Shari D Bolen
- Department of Medicine, Case Western Reserve University, Cleveland, OH, United States
- Center for Health Care Research and Policy, MetroHealth Medical Center, Cleveland, OH, United States
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Rihtman T, Morgan M, Booth J. The development of pre-registration occupational therapy student perceptions of research and evidence-based practice: A Q-methodology study. Scand J Occup Ther 2024; 31:2391318. [PMID: 39154225 DOI: 10.1080/11038128.2024.2391318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2024] [Accepted: 08/08/2024] [Indexed: 08/19/2024]
Abstract
BACKGROUND Pedagogically sound curricula are needed for occupational therapy (OT) students to adopt evidence-based practice (EBP) principles and internalise EBP within their professional identities. Exploring students' perceptions of this knowledge area can contribute to effective curriculum design. AIMS/OBJECTIVES To explore the evolution of pre-registration OT student perceptions of research and EBP over the course of their engagement with undergraduate teaching and learning. MATERIALS AND METHODS The Q-sort approach synthesises different viewpoints regarding a sample of statements, using by-person factor analysis (respondents = variables; statements = sample). Final year pre-registration OT students completed the same Q-sort at three timepoints (pre-dissertation [n = 18]; post-dissertation submission [n = 12]; post-student research conference [n = 6]). Q-sort responses were intercorrelated and factor-analysed; extraction of factors with an eigenvalue of ¬>0.9 and varimax rotation identified majority viewpoints. RESULTS Significant factors were revealed at each timepoint: 1a: 'Evidence-inseparable from OT practice', 1b: 'Research for research's sake-inseparable from the occupational therapy identity', 2: 'Who am I to question the gurus?', 3: 'I can do it with confidence…but so what?' CONCLUSIONS Opportunities for completing 'authentic' student research projects, with 'ownership' of results, may enhance research and EBP confidence and professional identity. SIGNIFICANCE Findings expand current knowledge regarding effective use of pre-registration educational opportunities to support future research and EBP.
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Affiliation(s)
- Tanya Rihtman
- Department of Sport, Health Sciences and Social Work, Faculty of Health and Life Sciences, Oxford Brookes University, Marston, Oxford, UK
| | - Mike Morgan
- School of Nursing, Midwifery & Health, Coventry University, Coventry, UK
| | - Julie Booth
- School of Nursing, Midwifery & Health, Coventry University, Coventry, UK
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11
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Yuan J, Mi L, Wang S, Cheng Y, Hou X. Comparing the influence of big data resources on medical knowledge recall for staff with and without medical collaboration platform. BMC MEDICAL EDUCATION 2023; 23:956. [PMID: 38093304 PMCID: PMC10720120 DOI: 10.1186/s12909-023-04926-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 12/01/2023] [Indexed: 12/17/2023]
Abstract
BACKGROUND This study aims to examine how big data resources affect the recall of prior medical knowledge by healthcare professionals, and how this differs in environments with and without remote consultation platforms. METHOD This study investigated two distinct categories of medical institutions, namely 132 medical institutions with platforms, and 176 medical institutions without the platforms. Big data resources are categorized into two levels-medical institutional level and public level-and three types, namely data, technology, and services. The data are analyzed using SmartPLS2. RESULTS (1) In both scenarios, shared big data resources at the public level have a significant direct impact on the recall of prior medical knowledge. However, there is a significant difference in the direct impact of big data resources at the institutional level in both scenarios. (2) In institutions with platforms, for the three big data resources (the medical big data assets and big data deployment technical capacity at the medical institutional level, and policies of medical big data at the public level) without direct impacts, there exist three indirect pathways. (3) In institutions without platforms, for the two big data resources (the service capability and big data technical capacity at the medical institutional level) without direct impacts, there exist three indirect pathways. CONCLUSIONS The different interactions between big data, technology, and services, as well as between different levels of big data resources, affect the way clinical doctors recall relevant medical knowledge. These interaction patterns vary between institutions with and without platforms. This study provides a reference for governments and institutions to design big data environments for improving clinical capabilities.
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Affiliation(s)
- JunYi Yuan
- Shanghai Chest Hospital, Shanghai Jiao Tong University School of Medicine, 241 West Huaihai Road, Shanghai, China
| | - Linhui Mi
- Shanghai Chest Hospital, Shanghai Jiao Tong University School of Medicine, 241 West Huaihai Road, Shanghai, China
| | - SuFen Wang
- Glorious Sun School of Business and Management, Donghua University, 1882 West Yanan Road, Shanghai, China
| | - Yuejia Cheng
- Shanghai Chest Hospital, Shanghai Jiao Tong University School of Medicine, 241 West Huaihai Road, Shanghai, China
| | - Xumin Hou
- Shanghai Chest Hospital, Shanghai Jiao Tong University School of Medicine, 241 West Huaihai Road, Shanghai, China.
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12
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Weller FS, Hamming JF, Repping S, van Bodegom-Vos L. What information sources do Dutch medical specialists use in medical decision-making: a qualitative interview study. BMJ Open 2023; 13:e073905. [PMID: 37798031 PMCID: PMC10565272 DOI: 10.1136/bmjopen-2023-073905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 09/19/2023] [Indexed: 10/07/2023] Open
Abstract
OBJECTIVE To explore what information sources medical specialists currently use to inform their medical decision-making. DESIGN Qualitative, semistructured interviews. SETTING AND PARTICIPANTS A total of 20 semistructured interviews were conducted with 10 surgeons and 10 internal medicine specialists who work in academic and/or regional hospitals in the Netherlands. RESULTS Medical specialists reported that they primarily rely on their general knowledge and experience, rather than actively using information sources. The sources they use to update their knowledge can be categorised into 'scientific publications', 'guidelines or protocols', and 'presentations and meetings'. When medical specialists feel their general knowledge and experience are insufficient, they use three different approaches to find answers in response to clinical questions: consulting a colleague, actively searching the literature and asking someone else to search the literature. CONCLUSION Medical specialists use information sources to update their general knowledge and to find answers to specific clinical questions when they feel their general knowledge and experience are insufficient. An important finding is that medical specialists prefer accessible information sources (eg, consulting colleagues) over existing evidence-based medicine tools.
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Affiliation(s)
- Floris S Weller
- Department of Surgery, Leiden University Medical Center, Leiden, The Netherlands
- Basic Data Siences-Medical Decision Making, Leiden University Medical Center, Leiden, The Netherlands
| | - Jaap F Hamming
- Department of Surgery, Leiden University Medical Center, Leiden, The Netherlands
| | - Sjoerd Repping
- Department of Health Evaluation and Appropriate Use, University of Amsterdam, Amsterdam, The Netherlands
| | - Leti van Bodegom-Vos
- Basic Data Siences-Medical Decision Making, Leiden University Medical Center, Leiden, The Netherlands
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Mohammadesmaeil S, Kianmehr S. Classifying the Factors Affecting Information Therapy to Support Clinical Decisions on Addiction. ADDICTION & HEALTH 2023; 15:156-162. [PMID: 38026721 PMCID: PMC10658106 DOI: 10.34172/ahj.2023.1325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Accepted: 05/09/2022] [Indexed: 12/01/2023]
Abstract
Background The present study aimed to identify the dimensions and components of developing an information therapy approach for clinical decisions on addiction in addiction treatment centers based on the opinions of thematic specialists in Iran using the fuzzy Delphi technique. Methods This study was a qualitative one conducted using Delphi method on 20 researchers of addiction treatment in the areas of psychiatry, psychology, medicine, etc. Findings The analysis of the data revealed 92 indicators in two dimensions, namely information dimension (health literacy) and treatment dimension (health services), each containing 6 components. The information dimension included acquiring information, identifying information, sharing information, raising awareness, information needs, and health knowledge, and the treatment dimension included patient satisfaction, information-seeking behaviors and skills, treatment methods and costs, participatory care and use of information, educational interventions, and disease prevention. Conclusion Developing an information therapy approach in addiction treatment, as a cost-effective and low-cost method, is one of the cognitive strategies that can be used by officials to pave the way for health in this regard. This technique aims to improve the quality of medical services and care for addicts and is a suitable solution to meet their needs.
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Affiliation(s)
- Sedigheh Mohammadesmaeil
- Department of Knowledge and Information Science, Islamic Azad University, Science and Research Branch, Tehran, Iran
| | - Shiba Kianmehr
- Student of Medical Library and Information Science, Tehran University of Medical Sciences, Tehran, Iran
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14
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Tan YXF, Lim STY, Lim JL, Ng TTM, Chng HT. Drug information-seeking behaviours of physicians, nurses and pharmacists: A systematic literature review. Health Info Libr J 2023; 40:125-168. [PMID: 36655603 DOI: 10.1111/hir.12472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Revised: 11/09/2022] [Accepted: 11/30/2022] [Indexed: 01/20/2023]
Abstract
BACKGROUND Medication use typically involves physicians prescribing, pharmacists reviewing, and nurses administering medications to patients. Drug information (DI) is often required during the process, with the various health care professionals (HCPs) seeking information differently according to their needs and familiarity with various resources. OBJECTIVE This systematic literature review aims to evaluate studies on drug information-seeking behaviour (ISB) of physicians, nurses and pharmacists to ascertain their DI needs, DI sources used, facilitators and barriers to DI-seeking. METHODS A systematic search was conducted on PubMed, Embase.com, Scopus, PsycINFO, CINAHL and Cochrane Library to identify eligible primary research articles published between January 2000 and May 2020. RESULTS The reviewed studies (N = 48) revealed that HCPs have a wide range of DI needs, with the top needs being similar across the three HCPs. Information sources used most often by all three groups were tertiary, followed by human and primary sources. Factors relating to the source characteristics were the most reported facilitators and barriers to DI-seeking. Some differences in drug ISB were also identified. CONCLUSION Our findings can also guide information providers and educators to optimize information provision. It may also facilitate effective communication amongst HCPs when obtaining DI from or providing DI to one another.
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Affiliation(s)
- Yu Xin Fiona Tan
- Department of Pharmacy, National University of Singapore, Singapore, Singapore
| | - Suzanne Tze Yin Lim
- Department of Pharmacy, National University of Singapore, Singapore, Singapore
| | - Jun Liang Lim
- Department of Pharmacy, National University of Singapore, Singapore, Singapore
| | | | - Hui Ting Chng
- Department of Pharmacy, National University of Singapore, Singapore, Singapore
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15
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Holzmann-Littig C, Stadler D, Popp M, Kranke P, Fichtner F, Schmaderer C, Renders L, Braunisch MC, Assali T, Platen L, Wijnen-Meijer M, Lühnen J, Steckelberg A, Pfadenhauer L, Haller B, Fuetterer C, Seeber C, Schaaf C. Locating Medical Information during an Infodemic: Information Seeking Behavior and Strategies of Health-Care Workers in Germany. Healthcare (Basel) 2023; 11:healthcare11111602. [PMID: 37297742 DOI: 10.3390/healthcare11111602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 05/14/2023] [Accepted: 05/28/2023] [Indexed: 06/12/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic has led to a flood of-often contradictory-evidence. HCWs had to develop strategies to locate information that supported their work. We investigated the information-seeking of different HCW groups in Germany. METHODS In December 2020, we conducted online surveys on COVID-19 information sources, strategies, assigned trustworthiness, and barriers-and in February 2021, on COVID-19 vaccination information sources. Results were analyzed descriptively; group comparisons were performed using χ2-tests. RESULTS For general COVID-19-related medical information (413 participants), non-physicians most often selected official websites (57%), TV (57%), and e-mail/newsletters (46%) as preferred information sources-physicians chose official websites (63%), e-mail/newsletters (56%), and professional journals (55%). Non-physician HCWs used Facebook/YouTube more frequently. The main barriers were insufficient time and access issues. Non-physicians chose abstracts (66%), videos (45%), and webinars (40%) as preferred information strategy; physicians: overviews with algorithms (66%), abstracts (62%), webinars (48%). Information seeking on COVID-19 vaccination (2700 participants) was quite similar, however, with newspapers being more often used by non-physicians (63%) vs. physician HCWs (70%). CONCLUSION Non-physician HCWs more often consulted public information sources. Employers/institutions should ensure the supply of professional, targeted COVID-19 information for different HCW groups.
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Affiliation(s)
- Christopher Holzmann-Littig
- Department of Nephrology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, 81675 Munich, Germany
- TUM Medical Education Center, School of Medicine, Technical University of Munich, 81675 Munich, Germany
| | - David Stadler
- Department of Nephrology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, 81675 Munich, Germany
| | - Maria Popp
- Department of Anaesthesiology, Intensive Care, Emergency and Pain Medicine, University Hospital Würzburg, 97080 Wuerzburg, Germany
| | - Peter Kranke
- Department of Anaesthesiology, Intensive Care, Emergency and Pain Medicine, University Hospital Würzburg, 97080 Wuerzburg, Germany
| | - Falk Fichtner
- Faculty of Medicine, Clinic and Polyclinic for Anesthesiology and Intensive Care, University of Leipzig, 04103 Leipzig, Germany
| | - Christoph Schmaderer
- Department of Nephrology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, 81675 Munich, Germany
| | - Lutz Renders
- Department of Nephrology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, 81675 Munich, Germany
| | - Matthias Christoph Braunisch
- Department of Nephrology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, 81675 Munich, Germany
| | - Tarek Assali
- Department of Nephrology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, 81675 Munich, Germany
| | - Louise Platen
- Department of Nephrology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, 81675 Munich, Germany
| | - Marjo Wijnen-Meijer
- TUM Medical Education Center, School of Medicine, Technical University of Munich, 81675 Munich, Germany
| | - Julia Lühnen
- Institute for Health and Nursing Science, Medical Faculty, Martin Luther University Halle-Wittenberg, 06112 Halle (Saale), Germany
- Clinic for Internal Medicine I, Martin Luther University Halle-Wittenberg, 06112 Halle (Saale), Germany
| | - Anke Steckelberg
- Institute for Health and Nursing Science, Medical Faculty, Martin Luther University Halle-Wittenberg, 06112 Halle (Saale), Germany
| | - Lisa Pfadenhauer
- Institute for Medical Information Processing, Biometry and Epidemiology-IBE, Chair of Public Health and Health Services Research, LMU Munich, 81377 Munich, Germany
- Pettenkofer School of Public Health, 81377 Munich, Germany
| | - Bernhard Haller
- Institute of AI and Informatics in Medicine, School of Medicine, Klinikum Rechts der Isar, Technical University of Munich, 81675 Munich, Germany
| | - Cornelia Fuetterer
- Institute of AI and Informatics in Medicine, School of Medicine, Klinikum Rechts der Isar, Technical University of Munich, 81675 Munich, Germany
| | - Christian Seeber
- Faculty of Medicine, Clinic and Polyclinic for Anesthesiology and Intensive Care, University of Leipzig, 04103 Leipzig, Germany
| | - Christian Schaaf
- Department of Nephrology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, 81675 Munich, Germany
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Seidel P, Rolander B, Eriksson AL, Lindahl U, Wallerstedt SM, Hägg S, Kling A. Drug information sources in professional work-a questionnaire study on physicians' usage and preferences (the drug information study). Eur J Clin Pharmacol 2023; 79:767-774. [PMID: 37059830 DOI: 10.1007/s00228-023-03494-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Accepted: 04/03/2023] [Indexed: 04/16/2023]
Abstract
PURPOSE This study aimed to explore physicians' use of drug information in professional work, with special focus on those working in primary care, and also in relation to personal characteristics of physicians. METHODS A web-based questionnaire was distributed by e-mail to physicians in five regions in Sweden. The questions concerned drug-related queries at issue when searching for information, sources used, and factors of importance for the choice of source, as well as responder characteristics. RESULTS A total of 3254 (85%) out of 3814 responding physicians stated that they searched for drug information every week. For physicians working in primary health care, the corresponding number was 585 (96%). The most common drug-related issues searched for by 76% of physicians every week concerned pharmacotherapeutic aspects (e.g., dosing), followed by adverse drug reactions (63%). For 3349 (88%) physicians, credibility was the most important factor for the choice of sources of drug information, followed by easy access online (n = 3127, 82%). Further analyses among physicians in primary care showed that some personal characteristics, like seniority, sex, and country of education, as well as research experience, were associated with usage and preferences of drug information sources. CONCLUSIONS This study confirms that physicians often use drug information sources in professional work, in particular those who work in primary health care. Credibility and easy access are key factors for usage. Among physicians in primary care, personal factors influenced the choice of drug information sources.
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Affiliation(s)
- Pia Seidel
- Department of Integrative Medical Biology, Clinical Pharmacology and Pharmacology, Umeå University, Umeå, Sweden.
| | - Bo Rolander
- Futurum-Academy for Healthcare, Region Jönköping County, Jönköping, Sweden
- Department of Behavioral Science and Social Work, School of Health Sciences, Jönköping University, Jönköping, Sweden
| | - Anna L Eriksson
- Department of Internal Medicine and Clinical Nutrition, University of Gothenburg, Gothenburg, Sweden
- Department of Clinical Pharmacology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | | | - Susanna M Wallerstedt
- Department of Pharmacology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- HTA-Centrum, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Staffan Hägg
- Futurum-Academy for Healthcare, Region Jönköping County, Jönköping, Sweden
- Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
| | - Anders Kling
- Department of Integrative Medical Biology, Clinical Pharmacology and Pharmacology, Umeå University, Umeå, Sweden
- Department of Clinical Science, Child and Adolescent Psychiatry, Umeå University, Umeå, Sweden
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17
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Wilson SN, Noble H, Ordoñez WJN, Wong GZ, Rodríguez MJ, Checa DO, Warne M, Senturia K, LaGrone LN. Implementing point-of-care medical information systems into trauma and general surgeon practice in a middle-income country: a qualitative study utilizing the Consolidated Framework for Implementation Research. Implement Sci Commun 2023; 4:38. [PMID: 37024984 PMCID: PMC10078056 DOI: 10.1186/s43058-023-00397-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Accepted: 02/04/2023] [Indexed: 04/08/2023] Open
Abstract
BACKGROUND Point-of-care medical information systems (POCMIS) can provide an efficient and effective means of strengthening health systems globally through their encouragement of continued medical education. Using the Consolidated Framework for Implementation Research (CFIR) as a guide, this research provides suggestions for improved implementation of POCMIS in low- and middle-income countries informed by an intervention implemented across public and military hospitals in Lima, Peru. METHODS Analysis is based on qualitative interviews conducted with 12 Peruvian surgeons across eight public hospitals and one military hospital who received an intervention that provided free access to UpToDate and introduced Google Translate. The post-intervention interviews were transcribed, translated, and analyzed for themes overlapping with CFIR constructs to expose barriers to implementation and suggestions for improved implementation of future interventions. RESULTS Barriers included a lack of seniority buy-in and engaged leadership, an overabundance of personal preferences for multiple POCMIS, and a culture of assumption that inhibited open communication regarding access to and use of POCMIS. Suggestions for improved implementation focused on the adaptation of the intervention. Namely, surgeons discussed regionally-specific adaptations as well as adaptations specific to their surgical specialty including visual, rather than written, representation of the information available via POCMIS. CONCLUSIONS Results indicate necessary adaptations for implementing interventions including POCMIS in LMICs, mimicking much of the implementation science literature on intervention adaptation. In addition to explicit suggestions provided by surgeons, we also suggest actionable steps to adapt to barriers identified in our data. Rapid assessment procedures (RAP) are one established methodological technique useful for assessing organization culture prior to implementation, allowing for necessary cultural adaptations. Dynamic adaption process (DAP) is another useful and established method that breaks implementation into four phases allowing for adaptations based on the initial assessment of the intervention site.
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Affiliation(s)
| | - Helen Noble
- Northern Pacific Global Health Fogarty International Program, University of Washington, Seattle, WA, USA
| | | | | | | | | | - Maria Warne
- University of Colorado Health, Denver, CO, USA
| | | | - Lacey Nicole LaGrone
- Department of Surgery, Medical Center of the Rockies, University of Colorado Health, Loveland, CO, USA.
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Savoy A, Patel H, Murphy DR, Meyer AND, Herout J, Singh H. Electronic Health Records' Support for Primary Care Physicians' Situation Awareness: A Metanarrative Review. HUMAN FACTORS 2023; 65:237-259. [PMID: 34033500 PMCID: PMC9969495 DOI: 10.1177/00187208211014300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Accepted: 03/31/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVE Situation awareness (SA) refers to people's perception and understanding of their dynamic environment. In primary care, reduced SA among physicians increases errors in clinical decision-making and, correspondingly, patients' risk of experiencing adverse outcomes. Our objective was to understand the extent to which electronic health records (EHRs) support primary care physicians (PCPs)' SA during clinical decision-making. METHOD We conducted a metanarrative review of papers in selected academic databases, including CINAHL and MEDLINE. Eligible studies included original peer-reviewed research published between January 2012 and August 2020 on PCP-EHR interactions. We iteratively queried, screened, and summarized literature focused on EHRs supporting PCPs' clinical decision-making and care management for adults. Then, we mapped findings to an established SA framework to classify external factors (individual, task, and system) affecting PCPs' levels of SA (1-Perception, 2-Comprehension, and 3-Projection) and identified SA barriers. RESULTS From 1504 articles identified, we included and synthesized 19 studies. Study designs were largely noninterventional. Studies described EHR workflow misalignments, usability issues, and communication challenges. EHR information, including lab results and care plans, was characterized as incomplete, untimely, or irrelevant. Unmet information needs made it difficult for PCPs to obtain even basic SA, Level 1 SA. Prevalent barriers to PCPs developing SA with EHRs were errant mental models, attentional tunneling, and data overload. CONCLUSION Based on our review, EHRs do not support the development of higher levels of SA among PCPs. Review findings suggest SA-oriented design processes for health information technology could improve PCPs' SA, satisfaction, and decision-making.
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Affiliation(s)
- April Savoy
- Indiana University-Purdue University Indianapolis, USA
- Richard L. Roudebush Veterans Affairs Medical Center,
Indianapolis, Indiana, USA
- Regenstrief Institute, Inc.,
Indianapolis, Indiana, USA
| | - Himalaya Patel
- Richard L. Roudebush Veterans Affairs Medical Center,
Indianapolis, Indiana, USA
| | - Daniel R. Murphy
- Michael E. DeBakey Veterans Affairs Medical Center, Houston,
Texas, USA
- Baylor College of Medicine, Houston, Texas, USA
| | - Ashley N. D. Meyer
- Michael E. DeBakey Veterans Affairs Medical Center, Houston,
Texas, USA
- Baylor College of Medicine, Houston, Texas, USA
| | - Jennifer Herout
- Veterans Health Administration, Office of Health Informatics,
Washington, DC, USA
| | - Hardeep Singh
- Michael E. DeBakey Veterans Affairs Medical Center, Houston,
Texas, USA
- Baylor College of Medicine, Houston, Texas, USA
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Desveaux L, Nguyen MD, Ivers NM, Devotta K, Upshaw T, Ramji N, Weyman K, Kiran T. Snakes and ladders: A qualitative study understanding the active ingredients of social interaction around the use of audit and feedback. Transl Behav Med 2023; 13:316-326. [PMID: 36694357 PMCID: PMC10182419 DOI: 10.1093/tbm/ibac114] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
Explore characteristics of the facilitator, group, and interaction that influence whether a group discussion about data leads to the identification of a clearly specified action plan. Peer-facilitated group discussions among primary care physicians were carried out and recorded. A follow-up focus group was conducted with peer facilitators to explore which aspects of the discussion promoted action planning. Qualitative data was analyzed using an inductive-deductive thematic analysis approach using the conceptual model developed by Cooke et al. Group discussions were coded case-specifically and then analyzed to identify which themes influenced action planning as it relates to performance improvement. Physicians were more likely to interact with practice-level data and explore actions for performance improvement when the group facilitator focused the discussion on action planning. Only one of the three sites (Site C) converged on an action plan following the peer-facilitated group discussion. At Site A, physicians shared skepticism of the data, were defensive about performance, and explained performance as a product of factors beyond their control. Site B identified several potential actions but had trouble focusing on a single indicator or deciding between physician- and group-level actions. None of the groups discussed variation in physician-level performance indicators, or how physician actions might contribute to the reported outcomes. Peer facilitators can support data interpretation and practice change; however their success depends on their personal beliefs about the data and their ability to identify and leverage change cues that arise in conversation. Further research is needed to understand how to create a psychologically safe environment that welcomes open discussion of physician variation.
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Affiliation(s)
- Laura Desveaux
- Institute for Better Health, Trillium Health Partners, 100 Queensway West, Mississauga, OntarioCanada.,Women's College Hospital Institute for Health Systems Solutions and Virtual Care, 76 Grenville Ave Toronto, Toronto, Ontario, Canada.,Institute for Health Policy, Management & Evaluation, University of Toronto, 155 College St, Toronto, Ontario, Canada
| | - Marlena Dang Nguyen
- Women's College Hospital Institute for Health Systems Solutions and Virtual Care, 76 Grenville Ave Toronto, Toronto, Ontario, Canada
| | - Noah Michael Ivers
- Women's College Hospital Institute for Health Systems Solutions and Virtual Care, 76 Grenville Ave Toronto, Toronto, Ontario, Canada.,Department of Family and Community Medicine, University of Toronto, 500 University Avenue, Toronto, Canada
| | - Kimberly Devotta
- MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute of St. Michael's Hospital, 30 Bond Street, Toronto, Canada.,Dalla Lana School of Public Health, University of Toronto, 155 College St, Toronto, Canada
| | - Tara Upshaw
- MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute of St. Michael's Hospital, 30 Bond Street, Toronto, Canada.,Dalla Lana School of Public Health, University of Toronto, 155 College St, Toronto, Canada
| | - Noor Ramji
- Department of Family and Community Medicine, University of Toronto, 500 University Avenue, Toronto, Canada.,Department of Family and Community Medicine, St. Michael's Hospital, 30 Bond Street, Toronto, Canada
| | - Karen Weyman
- Department of Family and Community Medicine, University of Toronto, 500 University Avenue, Toronto, Canada.,Department of Family and Community Medicine, St. Michael's Hospital, 30 Bond Street, Toronto, Canada
| | - Tara Kiran
- Institute for Health Policy, Management & Evaluation, University of Toronto, 155 College St, Toronto, Ontario, Canada.,Department of Family and Community Medicine, University of Toronto, 500 University Avenue, Toronto, Canada.,MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute of St. Michael's Hospital, 30 Bond Street, Toronto, Canada.,Department of Family and Community Medicine, St. Michael's Hospital, 30 Bond Street, Toronto, Canada
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20
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Wang W, Choi D, Yu CH. Effective web-based clinical practice guidelines resources: recommendations from a mixed methods usability study. BMC PRIMARY CARE 2023; 24:29. [PMID: 36694137 PMCID: PMC9872348 DOI: 10.1186/s12875-023-01974-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Accepted: 01/05/2023] [Indexed: 01/26/2023]
Abstract
BACKGROUND Clinical practice guidelines (CPG) are an important knowledge translation resource to help clinicians stay up to date about relevant clinical knowledge. Effective communication of guidelines, including format, facilitates its implementation. Despite the digitalization of healthcare, there is little literature to guide CPG website creation for effective dissemination and implementation. Our aim was to assess the effectiveness of the content and format of the Diabetes Canada CPG website, and use our results to inform recommendations for other CPG websites. METHODS Fourteen clinicians (family physicians, nurses, pharmacists, and dieticians) in diabetes care across Canada participated in this mixed-methods study (questionnaires, usability testing and interviews). Participants "thought-aloud" while completing eight usability tasks on the CPG website. Outcomes included task success rate, completion time, click per tasks, resource used, paths, search attempts and success rate, and error types. Participants were then interviewed. RESULTS The Diabetes Canada CPG website was found to be usable. Participants had a high task success rate of 79% for all tasks and used 144 (standard deviation (SD) = 152) seconds and 4.6 (SD = 3.9) clicks per task. Interactive tools were most frequently used compared to full guidelines and static tools. Misinterpretation accounted for 48% of usability errors. Participants overall found the website intuitive, with effective content and design elements. CONCLUSION Different versions of CPG information (e.g. interactive tools, quick reference guide, static tools) can help answer clinical questions more quickly. Effective web design should be assessed during CPG website creation for effective guideline dissemination and implementation.
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Affiliation(s)
- Wei Wang
- grid.17063.330000 0001 2157 2938Department of Medicine, University of Toronto, 1 King’s College Cir, Toronto, ON M5S 1A8 Canada
| | - Dorothy Choi
- grid.415502.7Li Ka Shing Knowledge Institute of St. Michael’s Hospital (Unity Health Toronto), 30 Bond Street, Toronto, ON M5B 1W8 Canada
| | - Catherine H. Yu
- grid.17063.330000 0001 2157 2938Department of Medicine, University of Toronto, 1 King’s College Cir, Toronto, ON M5S 1A8 Canada ,grid.415502.7Li Ka Shing Knowledge Institute of St. Michael’s Hospital (Unity Health Toronto), 30 Bond Street, Toronto, ON M5B 1W8 Canada
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Assaye BT, Kassa M, Belachew M, Birhanu S, Worku A. Association of digital health literacy and information-seeking behaviors among physicians during COVID-19 in Ethiopia: A cross-sectional study. Digit Health 2023; 9:20552076231180436. [PMID: 37312956 PMCID: PMC10259119 DOI: 10.1177/20552076231180436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 05/19/2023] [Indexed: 06/15/2023] Open
Abstract
Background Universal access to health information is a requirement for all global health strategies in the era of pandemics. Getting health information from the internet is a great concern for the quality of patient healthcare. This study aimed to determine the association between digital health literacy and information-seeking behavior among physicians during COVID-19. Methods An institutional-based cross-sectional study was conducted from December to February 2021 with a total sample size of 423. A pretest was performed among physicians before the actual data collection. After the data collection, the data were checked, cleaned, and exported into STATA v. 14. Descriptive statistics, binary logistic regression, and multivariable logistic regression analysis were applied. Then a 95% CI and a p-value of less than 0.05 were used to declare statistical significance. Results The study revealed that 53.81% of physicians had high digital health literacy and 52.46% had high information-seeking behaviors. Health information-seeking behaviors were determined by digital health literacy, which was 2.25 times more likely than those who had low digital health literacy (AOR = 2.25, 95% CI: [1.11-4.57]). Health-related websites (67.5%) were the most common sources of health information, and 63.30% of physicians find digital health literacy easy or very easy to learn. However, 206 (50.92%) find it difficult or very difficult to decide if the information is reliable, verified, and up-to-date. Internet access (AOR = 1.90, 95% CI: [1.16-3.12]), frequency of searching for information (AOR = 5.35, 95% CI: [2.01-14.29]). All were discovered to be significantly associated with physicians' health information-seeking behaviors. Conclusions Digital health literacy is a key to seeking health information online for appropriate decision-making. Increasing internet access, and providing ICT training, and integrate it into the health information revolution agendas, helping to disseminate health information and provide timely, reliable, and relevant news and genuine information needed for their work.
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Affiliation(s)
- Bayou Tilahun Assaye
- Department of Health informatics, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia
| | - Mitiku Kassa
- Department of Health informatics, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia
| | - Muluken Belachew
- Department of Health informatics, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia
| | - Sefefe Birhanu
- Department of Health informatics, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia
| | - Aynadis Worku
- Department of Health informatics, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia
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Medical practitioners’ decision making on quality of online medical information: A consumption values theory analysis. HEALTH POLICY AND TECHNOLOGY 2022. [DOI: 10.1016/j.hlpt.2022.100685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Muthu S, Chellamuthu G, Hathwar KSK, Ramakrishnan E, Dakshinamoorthy AP, Jeyaraman M. Analysis of Spin in RCTs of Spine Surgery Using ORG-LOC Grading Tool. Indian J Orthop 2022; 56:1882-1890. [PMID: 36310551 PMCID: PMC9561437 DOI: 10.1007/s43465-022-00697-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Accepted: 02/18/2022] [Indexed: 02/08/2023]
Abstract
BACKGROUND Even in highly credible research models, such as randomised control trials (RCTs), many pitfalls do exist that a practitioner must be aware of, to get the actual sense of the research. The one such pitfall that is much more common but ironically less explored is the Writers' bias or the spin. Particularly in the abstracts, it is a potential source of deception to the readers. METHODS We selected 250 recent RCTs from the top 5 spine journals. Baseline data and CONSORT Adherence Score (CAS) were collected. Abstracts of the RCTs were graded using the level of confidence (LOC) grading tool developed by the Orthopaedic Research Group. All possible associations of spin were studied to assess the significance. RESULTS The median CAS was 11 (IQR 10-12). Only 47.6% (n = 119) articles had High LOC with no or one non-critical spin in abstract. 12.4% (n = 31) had Moderate LOC and 28% (n = 70) had Low LOC. The rest had Critically Low LOC with more than one critical spin. Of the variables analyzed in multivariate regression analysis, only CAS had a (negative) correlation with the LOC of the abstracts. CONCLUSIONS Spin-based grading of RCTs is the need of the hour to aid readers to interpret the true essence of research papers. 40% of the RCTs in top spine journals had low to critically low LOC. Objective structuring of abstracts with adherence to CONSORT guidelines is the way forward to prevent spin.
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Affiliation(s)
- Sathish Muthu
- grid.512630.3Orthopaedic Research Group, Coimbatore, Tamil Nadu India
| | | | - K. S. Karthika Hathwar
- grid.415029.b0000 0004 1765 9100Department of Orthopaedics, Karnataka Institute of Medical Sciences, Hubli, Karnataka India
| | | | | | - Madhan Jeyaraman
- grid.512630.3Orthopaedic Research Group, Coimbatore, Tamil Nadu India
- grid.444354.60000 0004 1774 1403Department of Orthopaedics, Faculty of Medicine, Sri Lalithambigai Medical College and Hospital, Dr MGR Educational and Research Institute, Chennai, Tamil Nadu India
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Lunny C, Thirugnanasampanthar SS, Kanji S, Ferri N, Pieper D, Whitelaw S, Tasnim S, Nelson H, Reid EK, Zhang JH(J, Kalkat B, Chi Y, Abdoulrezzak R, Zheng DW, Pangka LR, Wang D(XR, Safavi P, Sooch A, Kang KT, Tricco AC. How can clinicians choose between conflicting and discordant systematic reviews? A replication study of the Jadad algorithm. BMC Med Res Methodol 2022; 22:276. [PMID: 36289496 PMCID: PMC9597955 DOI: 10.1186/s12874-022-01750-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Accepted: 10/04/2022] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION The exponential growth of published systematic reviews (SRs) presents challenges for decision makers seeking to answer clinical, public health or policy questions. In 1997, an algorithm was created by Jadad et al. to choose the best SR across multiple. Our study aims to replicate author assessments using the Jadad algorithm to determine: (i) if we chose the same SR as the authors; and (ii) if we reach the same results. METHODS We searched MEDLINE, Epistemonikos, and Cochrane Database of SRs. We included any study using the Jadad algorithm. We used consensus building strategies to operationalise the algorithm and to ensure a consistent approach to interpretation. RESULTS We identified 21 studies that used the Jadad algorithm to choose one or more SRs. In 62% (13/21) of cases, we were unable to replicate the Jadad assessment and ultimately chose a different SR than the authors. Overall, 18 out of the 21 (86%) independent Jadad assessments agreed in direction of the findings despite 13 having chosen a different SR. CONCLUSIONS Our results suggest that the Jadad algorithm is not reproducible between users as there are no prescriptive instructions about how to operationalise the algorithm. In the absence of a validated algorithm, we recommend that healthcare providers, policy makers, patients and researchers address conflicts between review findings by choosing the SR(s) with meta-analysis of RCTs that most closely resemble their clinical, public health, or policy question, are the most recent, comprehensive (i.e. number of included RCTs), and at the lowest risk of bias.
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Affiliation(s)
- C Lunny
- Unity Health Toronto and the Cochrane Hypertension Review Group, St Michael’s Hospital, University of British Columbia, V6T 1Z3 Vancouver, BC Canada
| | - Sai Surabi Thirugnanasampanthar
- Epidemiology Division, Institute for Health Policy, Management, and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON Canada
| | - S Kanji
- The Ottawa Hospital, Ottawa Hospital Research Institute, Ottawa, Canada
| | - N Ferri
- Division of Occupational Medicine, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- Department of Biomedical and Neuromotor Sciences (DIBINEM), Alma Mater Studiorum, University of Bologna, 40138 Bologna, Italy
| | - D Pieper
- Faculty of Health Sciences Brandenburg, Brandenburg Medical School Theodor Fontane, Institute for Health Services and Health System Research, Rüdersdorf, Germany
- Center for Health Services Research, Brandenburg Medical School Theodor Fontane, Rüdersdorf, Germany
| | - S Whitelaw
- Faculty of Medicine and Health Sciences, McGill University, Montreal, QC Canada
| | - S Tasnim
- Cochrane Hypertension Review Group, University of British Columbia, 2176 Health Science Mall, Vancouver, BC V6T 1Z3 Canada
| | - H Nelson
- Faculty of Health Sciences, Queen’s University, Kingston, ON Canada
| | - EK Reid
- Nova Scotia Health, Halifax, NS Canada
| | | | - Banveer Kalkat
- Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, BC Canada
| | - Yuan Chi
- Beijing Yealth Technology Co., Ltd, Beijing, China
- Cochrane Campbell Global Ageing Partnership, London, United Kingdom
| | - Reema Abdoulrezzak
- Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, BC Canada
| | - Di Wen Zheng
- Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, BC Canada
| | - Lindy R.S. Pangka
- Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, BC Canada
| | - Dian (Xin Ran) Wang
- Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, BC Canada
| | - Parisa Safavi
- Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, BC Canada
| | - Anmol Sooch
- Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, BC Canada
| | - Kevin T. Kang
- Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, BC Canada
| | - Andrea C, Tricco
- Knowledge Translation Program, Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Unity Health Toronto, 209 Victoria St, M5B 1T8 Toronto, ON Canada
- Epidemiology Division, Institute for Health Policy, Management, and Evaluation, Dalla Lana School of Public Health, University of Toronto, 155 College St Room 500, M5T 3M7 Toronto, ON Canada
- Queen’s Collaboration for Health Care Quality Joanna Briggs Institute Centre of Excellence, School of Nursing, Queen’s University, 99 University Ave, K7L 3N6 Kingston, ON Canada
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Wang S, Yuan J, Pan C. Impact of big data resources on clinicians’ activation of prior medical knowledge. Heliyon 2022; 8:e10312. [PMID: 36105474 PMCID: PMC9465108 DOI: 10.1016/j.heliyon.2022.e10312] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 07/10/2022] [Accepted: 08/11/2022] [Indexed: 11/30/2022] Open
Abstract
Background Activating prior medical knowledge in diagnosis and treatment is an important basis for clinicians to improve their care ability. However, it has not been systematically explained whether and how various big data resources affect the activation of prior knowledge in the big data environment faced by clinicians. Objective The aim of this study is to contribute to a better understanding on how the activation of prior knowledge of clinicians is affected by a wide range of shared and private big data resources, to reveal the impact of big data resources on clinical competence and professional development of clinicians. Method Through the comprehensive analysis of extant research results, big data resources are classified as big data itself, big data technology and big data services at the public and institutional levels. A survey was conducted on clinicians and IT personnel in Chinese hospitals. A total of 616 surveys are completed, involving 308 medical institutions. Each medical institution includes a clinician and an IT personnel. SmartPLS version 2.0 software package was used to test the direct impact of big data resources on the activation of prior knowledge. We further analyze their indirect impact of those big data resources without direct impact. Results (1) Big data quality environment at the institutional level and the big data sharing environment at the public level directly affect activation of prior medical knowledge; (2) Big data service environment at the institutional level directly affects activation of prior medical knowledge; (3) Big data deployment environment at the institutional level and big data service environment at the public level have no direct impact on activation of prior knowledge of clinicians, but they have an indirect impact through big data quality environment and service environment at the institutional level and the big data sharing environment at the public level. Conclusions Big data technology, big data itself and big data service at the public level and institutional level interact and influence each other to activate prior medical knowledge. This study highlights the implications of big data resources on improvement of clinicians’ diagnosis and treatment ability.
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Affiliation(s)
- Sufen Wang
- Glorious Sun School of Business and Management, DongHua University, Shanghai, China
| | - Junyi Yuan
- Information Center, Shanghai Chest Hospital, Shanghai Jiaotong University, Shanghai, China
- Corresponding author.
| | - Changqing Pan
- Hospital's Office, Shanghai Chest Hospital, Shanghai Jiaotong University, Shanghai, China
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Halder J, Zirngibl I, Joos S, Förster C. [Point-of-care information in GP practices: Results of a survey among German GP specialists and GP trainees]. ZEITSCHRIFT FUR EVIDENZ, FORTBILDUNG UND QUALITAT IM GESUNDHEITSWESEN 2022; 172:92-99. [PMID: 35773084 DOI: 10.1016/j.zefq.2022.04.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 04/08/2022] [Accepted: 04/12/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Specific questions often arise in the context of consultations regarding, for example, diagnostics and therapeutic management. This case-specific search for information is referred to as point-of-care information. In recent years, it has been influenced by an increase in digitalization and by the development of medical expert systems providing information for medical professionals. Data on the search behavior of German general practitioners (GPs) using digital media for obtaining point-of-care information have so far not been available. The aims of this study were to describe occasion-related point-of-care information as a function of the continuing education status and to identify requirements for online research platforms. METHODS In a cross-sectional survey, 829 GP specialists (FÄ) and 475 physicians in training (ÄiW) were invited to answer a self-developed, partially standardized questionnaire. RESULTS In total, 356 questionnaires were returned (response rate: 27%). Of these, 241 (68%) were answered by FÄ and 110 (31%) by ÄiW; five participants did not provide information on their specialist status. 66% of the FÄ and 89% of the ÄiW look up information every day. 46% of the FÄ and 73% of the ÄiW use their smartphone for this purpose. Both groups most often search for medical content (94%) and for information on medications (84%). Medical expert systems are more often used by ÄiW than by FÄ; 59% of the FÄ and 82% of the ÄiW are willing to pay a fee for these services. A quick overview and relevance of information were perceived as important criteria for good information sources. DISCUSSION German GPs frequently search for occasion-related information. There are generation-related differences regarding, among other things, the use of and the receptiveness to fee-based expert systems. The clarity of presentation and the relevance of the information provided are important requirements of effective information platforms. CONCLUSION The quick search for evidence-based information relevant to clinical practice presents a challenge, particularly in broad-range specialties such as general medicine. Web-based sources are becoming increasingly popular in this regard - a trend likely to intensify in future generations of physicians. This offers great potential for medical expert systems and app-based access to best-practice guidelines. These formats should be further developed in collaboration with scientific professional societies.
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Affiliation(s)
- Julian Halder
- Universitätsklinikum Tübingen, Institut für Allgemeinmedizin und Interprofessionelle Versorgung, Tübingen, Deutschland
| | - Isabella Zirngibl
- Universitätsklinikum Tübingen, Institut für Allgemeinmedizin und Interprofessionelle Versorgung, Tübingen, Deutschland
| | - Stefanie Joos
- Universitätsklinikum Tübingen, Institut für Allgemeinmedizin und Interprofessionelle Versorgung, Tübingen, Deutschland
| | - Christian Förster
- Universitätsklinikum Tübingen, Institut für Allgemeinmedizin und Interprofessionelle Versorgung, Tübingen, Deutschland.
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Tranter I, van Driel ML, Mitchell B. Doctor! Did you Google my symptoms? A qualitative study of patient perceptions of doctors' point-of-care information seeking. BMJ Open 2022; 12:e061090. [PMID: 35896298 PMCID: PMC9335025 DOI: 10.1136/bmjopen-2022-061090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE To explore patient perceptions regarding doctors' information seeking during consultations. DESIGN AND SETTING Qualitative interviews with participants from six general practice waiting rooms in South East Queensland, Australia. Participants were asked about their experiences and opinions, and to comment on short videos of simulated consultations in which a doctor sought information. The interviews were analysed through a process of iterative thematic analysis using the framework of Braun and Clarke. PARTICIPANTS The 16 participants were purposively sampled including 5 men and 11 women from a diverse range of educational and age groups. RESULTS How a doctor's need to look up information impacted patient impressions of competence and trust was an overarching theme. The four dominant themes include: the trust a patient has in the doctor before the consultation, whether the doctor is expected to know the answer to a question without searching, has the doctor added value to the consultation by searching and the consultation skills used in the process. CONCLUSIONS Patient trust is fundamental to positive perceptions of general practitioners' information seeking at the point-of-care. Communication is key to building this trust. Understanding the patient's agenda, listening, assessing thoroughly and being honest and transparent about the need to seek information all contribute to a positive experience.
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Affiliation(s)
- Isaac Tranter
- General Practice Clinical Unit, The University of Queensland Faculty of Medicine and Biomedical Sciences, Herston, Queensland, Australia
| | - Mieke L van Driel
- General Practice Clinical Unit, The University of Queensland Faculty of Medicine and Biomedical Sciences, Herston, Queensland, Australia
| | - Ben Mitchell
- General Practice Clinical Unit, The University of Queensland Faculty of Medicine and Biomedical Sciences, Herston, Queensland, Australia
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Egyptian physicians' information-seeking behavior while serving in public isolation hospitals for coronavirus patients. ONLINE INFORMATION REVIEW 2022. [DOI: 10.1108/oir-08-2020-0350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PurposeThe purpose of this study is to explore the information-seeking behavior of Egyptian physicians serving in COVID-19 isolation hospitals.Design/methodology/approachA sample of 91 physicians serving in Egyptian isolation hospitals answered the study questionnaire.FindingsDemographically, more than half of respondents were males. Over one-third of them are holding Doctor of Medicine (M.D), followed by one-third holding Master of Medicine (MMed). Respondents' age ranged from 30 to 60 years. Internal medicine is the most common specialty, accounting for nearly half of all physicians, followed by chest medicine and intensive care medicine. The information-seeking behavior of these three groups in their regular work is believed to be different, but since all of the participants are working in COVID-19 isolation hospitals, they should have the same information resources, Internet access and the same needs relevant to COVID-19 in order to make accurate clinical decisions. The physicians used traditional and electronic information sources to fulfill their information needs, the most important of which were to make a specific research, find an answer to a specific case, and deliver a medical lecture. Colleagues, coworkers, nurses and pharmacists were the most important channels pursued by Egyptian physicians to obtain information.Originality/valueThis study is the first study that focuses on investigating the information-seeking behavior of Egyptian physicians serving in isolation hospitals. Any findings resulted from this study may serve as a noteworthy reference that may be useful to the Egyptian health sector, experts, researchers, as well as policymakers in establishing strategic decisions for making the understating much better.Peer reviewThe peer review history for this article is available at: https://publons.com/publon/10.1108/OIR-08-2020-0350
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Antoun J, Lapin J, Beck D. Information retrieval at the point of care of community family physicians in Arab countries. Health Info Libr J 2022; 39:178-184. [PMID: 35396788 DOI: 10.1111/hir.12429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Accepted: 03/18/2022] [Indexed: 11/30/2022]
Abstract
This study is based on Jumana Antoun's PhD thesis at Walden University, USA examining the information retrieval behaviour of 72 community family physicians' at the point of care in eight Arab countries in the Eastern Mediterranean. The key findings were that participants looked for digital clinical information at the point of care on average 14.0 times per week with the majority (80.3%) using a mobile phone. Clinical information about medication dosage and side effects was the most sought clinical question, and patient education was the least. Almost half of the participants considered that they often found relevant (55.6%), useful (56.9%) and unbiased (58.3%) information. Whilst none of the factors examined predicted the physicians' self-reported effectiveness and efficiency at information retrieval, the implication for practice points clearly to the barriers and the need for curricula to focus on search strategies using free resources at the point of care.
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Affiliation(s)
- Jumana Antoun
- Department of Family Medicine, American University of Beirut, Beirut, Lebanon
| | - Jennifer Lapin
- Richard W. Riley College of Education and Leadership, Walden University, Minneapolis, Minnesota, USA
| | - Dennis Beck
- Department of Educational Technology, University of Arkansas, Fayetteville, Arkansas, USA
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Pieper D, Hoffmann F. Retrieving Cochrane reviews is sometimes challenging and their reporting is not always optimal. Res Synth Methods 2022; 13:554-557. [PMID: 35583946 DOI: 10.1002/jrsm.1564] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 04/18/2022] [Accepted: 04/22/2022] [Indexed: 11/06/2022]
Abstract
Cochrane reviews are known to be a high quality source of evidence synthesis supporting health care decisions. In a recently conducted study, we analysed the trends in epidemiology and reporting of published systematic reviews over the last 20 years. This sample of 1,132 systematic reviews included 84 Cochrane reviews. We have learned several peculiarities of Cochrane reviews, that are worth being discussed in more detail due to their practical implications. Methodologists, clinicians and health care professionals should be aware of these limitations: 1) Cochrane reviews are not identified as systematic reviews in title, 2) Cochrane reviews do not always follow PRISMA reporting guidelines, 3) Some updates are only available via the Cochrane Library, and 4) Indexing of Cochrane Reviews in PubMed may be suboptimal. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Dawid Pieper
- Faculty of Health Sciences Brandenburg, Brandenburg Medical School Theodor Fontane, Institute for Health Services and Health System Research, Rüdersdorf, Germany.,Center for Health Services Research, Brandenburg Medical School Theodor Fontane, Rüdersdorf, Germany
| | - Falk Hoffmann
- Department of Health Services Research, School of Medicine and Health Sciences, Carl von Ossietzky University Oldenburg, Oldenburg, Germany
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Healthcare Professionals' Compliance with the Standard Management Guidelines towards the Use of Biological Disease-Modifying Anti-Rheumatic Drugs in Rheumatoid Arthritis Patients. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19084699. [PMID: 35457564 PMCID: PMC9025247 DOI: 10.3390/ijerph19084699] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 03/30/2022] [Accepted: 04/11/2022] [Indexed: 02/04/2023]
Abstract
Treatment of rheumatoid arthritis (RA) is complicated, with numerous aspects influencing decision-making, including disease severity, comorbidities, and patient preferences. The present study aimed to evaluate healthcare professionals' (HCPs) knowledge of biological disease-modifying anti-rheumatic drugs (bDMARDs) and their compliance with the standard management guidelines for assuring optimal RA therapy. The cross-sectional, survey-based study was performed in various healthcare and academic settings in Karachi, Pakistan to probe HCPs' knowledge of bDMARDs and their compliance with the European League against Rheumatism (EULAR) recommendations for the management of RA patients. Overall, n = 413 questionnaires were included in our study (response rate: 82.6%). The physicians were further well-informed about the indications (n = 276, 91.3%, p = 0.001) and monitoring requirements (n = 258, 85.4%, p = 0.004). The pharmacists were more knowledgeable about the drug targets (n = 96, 86.4%, p = 0.029) and their mechanisms of action (n = 80, 72.0%, p = 0.013). Male respondents as compared with females (41.3% vs. 35.6%, p = 0.04), and physicians as compared with pharmacists (40.7% vs. 37.8%, p = 0.012), were more confident in using bDMARDs than conventional treatment in RA patients. Our findings show that the respondents were familiar with the attributes of bDMARDs and the standard management guidelines for RA care. Our results may be relevant in creating new methods, guidelines, and treatments to enhance RA treatment adherence, satisfaction, and health outcomes.
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Stenzl A, Sternberg CN, Ghith J, Serfass L, Schijvenaars BJA, Sboner A. Application of Artificial Intelligence to Overcome Clinical Information Overload in Urologic Cancer. BJU Int 2021; 130:291-300. [PMID: 34846775 DOI: 10.1111/bju.15662] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To describe the use of artificial intelligence (AI) in medical literature and trial data extraction, and its applications in uro-oncology. This bridging review, which consolidates information from the diverse applications of AI, highlights how AI users can investigate more sophisticated queries than with traditional methods, leading to synthesis of raw data and complex outputs into more actionable and personalized results, particularly in the field of uro-oncology. METHODS Literature and clinical trial searches were performed in PubMed, Dimensions, Embase and Google (1999-2020). The searches focused on the use of AI and its various forms to facilitate literature searches, clinical guidelines development, and clinical trial data extraction in uro-oncology. To illustrate how AI can be applied toaddress questions about optimizing therapeutic decision making and individualizing treatment regimens, the Dimensions-linked information platform was searched for "prostate cancer" keywords (76 publications were identified; 48 were included). RESULTS AI offers the promise of transforming raw data and complex outputs into actionable insights. Literature and clinical trial searches can be automated, enabling clinicians to develop and analyze publications expeditiously on complex issues such as therapeutic sequencing and to obtain updates on documents that evolve at the pace and scope of the landscape. An AI-based platform inclusive of 12 trial databases and >100 scientific literature sources enabled the creation of an interactive visualization. CONCLUSION As the literature and clinical trial landscape continues to grow in complexity and with increasing speed, the ability to pull the right information at the right time from different search engines and resources while excluding social media bias becomes more challenging. This review demonstrates that by applying natural language processing and machine learning algorithms, validated and optimized AI leads to a speedier, more personalized, efficient and focused search compared with traditional methods.
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Affiliation(s)
- Arnulf Stenzl
- Department of Urology, University of Tübingen, Tübingen, Germany
| | - Cora N Sternberg
- Clinical Director, Englander Institute for Precision Medicine, Professor of Medicine, Weill Cornell Medicine Hematology/Oncology, Sandra and Edward Meyer Cancer Center, New York, NY, USA
| | | | | | | | - Andrea Sboner
- Director of Informatics and Computational Biology, Englander Institute for Precision Medicine; Assistant Professor at the Department of Pathology and Laboratory Medicine, Weill Cornell Medicine, New York, NY, USA
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Laws S. Information-Seeking Behaviors of Medical Faculty at a Qatar Academic Medical Institution. Med Ref Serv Q 2021; 40:274-291. [PMID: 34495806 DOI: 10.1080/02763869.2021.1945863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Medical faculty are among the most important user groups at any academic medical library. Knowing how medical faculty identify, access, and use information is important for collection development and instruction. This study found that medical faculty at an institution in Qatar identified information access and use as vital in their professional duties. However, they also noted limitations that warrant attention by the library to better serve this user group. Further, the results of this study were compared to a similar study of medical faculty in the United States, with noted similarities and differences in their access and use of information.
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Affiliation(s)
- Sa'ad Laws
- Distributed eLibrary, Weill Cornell Medicine - Qatar, Doha
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Chellamuthu G, Muthu S, Damodaran UK, Rangabashyam R. "Only 50% of randomized trials have high level of confidence in arthroscopy and sports medicine"-a spin-based assessment. Knee Surg Sports Traumatol Arthrosc 2021; 29:2789-2798. [PMID: 34021767 DOI: 10.1007/s00167-021-06614-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Accepted: 05/17/2021] [Indexed: 02/08/2023]
Abstract
PURPOSE Pioneering works on the quality appraisal of RCTs have recognized and addressed most of the issues that affect the RCT quality but some issues such as "Writers' bias" or "Spin" are yet to be sorted out. Spin, particularly in the abstracts, is a potential source of deception to the readers. The purpose of this study is to grade the RCTs of arthroscopy and sports medicine based on a spin in their abstracts, analyze the prevalence of spin, and explore methods to remove spin. METHODS 250 recent RCTs from the top 5 arthroscopy and sports medicine journals were selected. Baseline data of the articles were collected. Consort Adherence Score (CAS) was calculated. The abstracts of the RCTs were graded using the Level Of Confidence (LOC) grading tool developed by the Orthopaedic Research Group. The association of the spin grade with other characteristics of the articles was analyzed. RESULTS The median CAS for the included studies was 9 (IQR 8-10). It was found that only 49.6% (n = 124) articles had high LOC with no or one non-critical spin in the abstract. 20.8% (n = 52) had Moderate LOC with more than one non-critical spin. 19.6% (n = 49) had at least one critical spin and 10% (n = 25) had more than one critical flaw making their results have Low and Critically Low LOC, respectively. Of the ten variables analyzed in multivariate regression analysis, it was found that CAS was the only significant factor that determines the level of confidence in the abstract of RCTs CONCLUSION: Spin is prevalent in abstracts of sports medicine and arthroscopy journals with 50.4% having some form of spin. Grading the LOC of the RCTs based on spin is the necessity of the day for the readers. Only 49.6% of the RCTs had high LOC. Objective structuring of the abstracts would help eliminate spin in the future. LEVEL OF EVIDENCE Level 1.
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Affiliation(s)
| | - Sathish Muthu
- Orthopaedic Research Group, Coimbatore, Tamil Nadu, India.
- Government Hospital, Velayuthampalayam, Karur, Tamil Nadu, India.
| | - Udaya Kumar Damodaran
- Orthopaedic Research Group, Coimbatore, Tamil Nadu, India
- Government Mohan Kumaramangalam Medical College, Salem, Tamil Nadu, India
| | - Rajkumar Rangabashyam
- Orthopaedic Research Group, Coimbatore, Tamil Nadu, India
- Central Prison Hospital Vellore, Vellore, Tamil Nadu, India
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Girinivasan C, Sathish M. Analysis of Reference Practices among Practicing Orthopaedicians in India. Indian J Orthop 2021; 55:869-878. [PMID: 34194641 PMCID: PMC8192656 DOI: 10.1007/s43465-021-00350-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Accepted: 01/02/2021] [Indexed: 02/05/2023]
Abstract
PURPOSE On-The-Go (OTG) references are those that clinicians make within a tight deadline at the point of patient care to direct critical decisions. We conducted this study to assess the knowledge level of orthopaedicians on clinical usefulness and quality appraisal of different reference methods along with their attitude towards its utility for practice. MATERIALS AND METHODS A web-based survey was administered through Google Forms among the members of the Tamil Nadu Orthopaedic Association (TNOA) by snowball sampling method. The survey was designed by the Quality Appraisal Committee (QAC) of Orthopaedic Research Group (ORG) with 17 items. Association and correlation analysis were done between different responses in the survey to find out ways to improve the reference practices. RESULTS 177 participants with a mean age of 43.5 years completed the survey. About 45.8% (n = 81) of participants had prior knowledge on the Oxford Levels of Evidence. However, they were not familiar with using them for critical appraisal of evidence. About 86.5% (n = 153) of participants were worried about the quality of the content they seek for reference. Among the reference sources, online research articles were used by 54.2% (n = 96), digital applications by 21.4% (n = 38), digital textbooks by 15.2% (n = 27), and other methods like peer discussion by 5.1% (n = 9). A significant association was noted between the participants who chose level I studies for their reference and their familiarity with the concept of fragility (p = 0.006) and heterogenicity (p = 0.021) and types of bias (p = 0.003). A significant association was noted between participants with active journal subscription and their familiarity with the concept of spin (p = 0.016) and their knowledge of the heterogeneity of study results (p = 0.019). We found a significant association between age (< 40 years of age) and knowledge on various types of bias (p = 0.032), heterogenicity (p = 0.01), and fragility (p = 0.021). CONCLUSION This is the first study on the information-seeking behaviour of the orthopaedicians. OTG references remain a part of the orthopaedic practice and are made mostly by accessing online research articles. Imparting knowledge of their quality appraisal should be an active part of the orthopaedic curriculum. This will, in turn, improve the attitude and reference practices leading to better decision-making towards patient care.
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Affiliation(s)
| | - Muthu Sathish
- Orthopaedic Research Group, Coimbatore, Tamil Nadu India
- Government Hospital, Velayuthampalayam, Karur, Tamil Nadu India
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Abstract
OBJECTIVE Human factors and ergonomics (HF/E) frameworks and methods are becoming embedded in the health informatics community. There is now broad recognition that health informatics tools must account for the diverse needs, characteristics, and abilities of end users, as well as their context of use. The objective of this review is to synthesize the current nature and scope of HF/E integration into the health informatics community. METHODS Because the focus of this synthesis is on understanding the current integration of the HF/E and health informatics research communities, we manually reviewed all manuscripts published in primary HF/E and health informatics journals during 2020. RESULTS HF/E-focused health informatics studies included in this synthesis focused heavily on EHR customizations, specifically clinical decision support customizations and customized data displays, and on mobile health innovations. While HF/E methods aimed to jointly improve end user safety, performance, and satisfaction, most HF/E-focused health informatics studies measured only end user satisfaction. CONCLUSION HF/E-focused health informatics researchers need to identify and communicate methodological standards specific to health informatics, to better synthesize findings across resource intensive HF/E-focused health informatics studies. Important gaps in the HF/E design and evaluation process should be addressed in future work, including support for technology development platforms and training programs so that health informatics designers are as diverse as end users.
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Patient Satisfaction with Private Recovery Services and Importance of Physician Behavior during COVID Time. Healthcare (Basel) 2021; 9:healthcare9080928. [PMID: 34442065 PMCID: PMC8394884 DOI: 10.3390/healthcare9080928] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 07/16/2021] [Accepted: 07/20/2021] [Indexed: 11/26/2022] Open
Abstract
Introduction: Patient satisfaction represents an essential indicator of the quality of care in the medical recuperation sector. This study aimed to identify the degree of satisfaction in patients who benefit from medical recuperation services in one private clinic from Romania and the factors that played a part in this respect. Method: An online questionnaire was completed by 105 patients of a private clinic in the period immediately following the opening of the clinic after the quarantine period due to COVID-19. The following concepts were measured: general satisfaction with clinical recuperation services (SG), physician’s behavior (PB), the impact of interventions on the state of health (IHI), modern equipment (ME), and the intention to return to the clinic (IRC). Based on a linear regression model, the impact of PB, IHI, ME, and IRC variables on general satisfaction (SG) was established. Results: The study results confirm the data from studies carried out in different sociocultural contexts in ordinary time, where physician behavior is the most crucial factor in patients’ satisfaction. Therefore, we can say that the physiotherapist’s behavior has an essential role in determining the patients’ satisfaction both in ordinary time and in COVID-19 time. The data in this study reflect the fact that satisfaction with the services offered by a medical recuperation clinic is a predictor for using the services in the future. Still, our study reflects a moderate relationship in intensity.
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Laera E, Gutzman K, Spencer A, Beyer C, Bolore S, Gallagher J, Pidgeon S, Rodriguez R. Why are they not accessing it? User barriers to clinical information access. J Med Libr Assoc 2021; 109:126-132. [PMID: 33424474 PMCID: PMC7772983 DOI: 10.5195/jmla.2021.1051] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The Medical Library Association's InSight Initiative provides an open and collaborative environment for library and industry partners to discuss vexing problems and find solutions to better serve their users. The initiative's fifth summit, continuing work from the previous summit, focused on understanding how users discover and access information in the clinical environment. During the summit, participants were divided into working groups and encouraged to create a tangible product as a result of their discussions. At the end of the summit, participants established a framework for understanding users' pain points, discussed possible solutions to those points, and received feedback on their work from an End User Advisory Board comprising physicians, clinical researchers, and clinical faculty in biomedicine. In addition to the pain point framework, participants are developing MLA InSight Initiative Learning content with modules to educate librarians and publishers about critical aspects of user behavior. The 2020 Insight Initiative Fall Forum will serve as a virtual home for constructive dialogue between health sciences librarians and publishers on improving discovery and access to information.
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Affiliation(s)
- Elizabeth Laera
- , Medical Librarian, McMahon-Sibley Medical Library, Brookwood Baptist Health, Birmingham, AL
| | - Karen Gutzman
- , Head, Research Assessment and Communications, Galter Health Sciences Library & Learning Center, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - Angela Spencer
- , Assistant Professor, Medical Center Library, Saint Louis University, St. Louis MO
| | - Charlotte Beyer
- , Library Director, Boxer Library, Rosalind Franklin University of Medicine and Science, North Chicago, IL
| | - Saskia Bolore
- , Sales Manager, JAMA Network, American Medical Association, Chicago, IL
| | - John Gallagher
- , Director, Cushing/Whitney Medical Library, Yale University, New Haven, CT
| | - Sean Pidgeon
- , Publishing Director, Science & Medicine, Oxford University Press, New York, NY
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Doherty C, Joorabchi A, Megyesi P, Flynn A, Caulfield B. Physiotherapists' Use of Web-Based Information Resources to Fulfill Their Information Needs During a Theoretical Examination: Randomized Crossover Trial. J Med Internet Res 2020; 22:e19747. [PMID: 33331826 PMCID: PMC7775194 DOI: 10.2196/19747] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 07/06/2020] [Accepted: 11/11/2020] [Indexed: 11/23/2022] Open
Abstract
Background The widespread availability of internet-connected smart devices in the health care setting has the potential to improve the delivery of research evidence to the care pathway and fulfill health care professionals’ information needs. Objective This study aims to evaluate the frequency with which physiotherapists experience information needs, the capacity of digital information resources to fulfill these needs, and the specific types of resources they use to do so. Methods A total of 38 participants (all practicing physiotherapists; 19 females, 19 males) were randomly assigned to complete three 20-question multiple-choice questionnaire (MCQ) examinations under 3 conditions in a randomized crossover study design: assisted by a web browser, assisted by a federated search portal system, and unassisted. MCQ scores, times, and frequencies of information needs were recorded for overall examination-level and individual question-level analyses. Generalized estimating equations were used to assess differences between conditions for the primary outcomes. A log file analysis was conducted to evaluate participants’ web search and retrieval behaviors. Results Participants experienced an information need in 55.59% (845/1520) MCQs (assisted conditions only) and exhibited a mean improvement of 10% and 16% in overall examination scores for the federated search and web browser conditions, respectively, compared with the unassisted condition (P<.001). In the web browser condition, Google was the most popular resource and the only search engine used, accounting for 1273 (64%) of hits, followed by PubMed (195 hits; 10% of total). In the federated search condition, Wikipedia and PubMed were the most popular resources with 1518 (46% of total) and 1273 (39% of total) hits, respectively. Conclusions In agreement with the findings of previous research studies among medical physicians, the results of this study demonstrate that physiotherapists frequently experience information needs. This study provides new insights into the preferred digital information resources used by physiotherapists to fulfill these needs. Future research should clarify the implications of physiotherapists’ apparent high reliance on Google, whether these results reflect the authentic clinical environment, and whether fulfilling clinical information needs alters practice behaviors or improves patient outcomes.
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Affiliation(s)
- Cailbhe Doherty
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland.,Insight Centre for Data Analytics, O'Brien Centre for Science, University College Dublin, Dublin, Ireland
| | - Arash Joorabchi
- Insight Centre for Data Analytics, O'Brien Centre for Science, University College Dublin, Dublin, Ireland.,Department of Electronic & Computer Engineering, University of Limerick, Limerick, Ireland
| | - Peter Megyesi
- Insight Centre for Data Analytics, O'Brien Centre for Science, University College Dublin, Dublin, Ireland
| | | | - Brian Caulfield
- Insight Centre for Data Analytics, O'Brien Centre for Science, University College Dublin, Dublin, Ireland
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Lazarus JV, Palayew A, Rasmussen LN, Andersen TH, Nicholson J, Norgaard O. Searching PubMed to Retrieve Publications on the COVID-19 Pandemic: Comparative Analysis of Search Strings. J Med Internet Res 2020; 22:e23449. [PMID: 33197230 PMCID: PMC7695541 DOI: 10.2196/23449] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Revised: 10/10/2020] [Accepted: 10/24/2020] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Since it was declared a pandemic on March 11, 2020, COVID-19 has dominated headlines around the world and researchers have generated thousands of scientific articles about the disease. The fast speed of publication has challenged researchers and other stakeholders to keep up with the volume of published articles. To search the literature effectively, researchers use databases such as PubMed. OBJECTIVE The aim of this study is to evaluate the performance of different searches for COVID-19 records in PubMed and to assess the complexity of searches required. METHODS We tested PubMed searches for COVID-19 to identify which search string performed best according to standard metrics (sensitivity, precision, and F-score). We evaluated the performance of 8 different searches in PubMed during the first 10 weeks of the COVID-19 pandemic to investigate how complex a search string is needed. We also tested omitting hyphens and space characters as well as applying quotation marks. RESULTS The two most comprehensive search strings combining several free-text and indexed search terms performed best in terms of sensitivity (98.4%/98.7%) and F-score (96.5%/95.7%), but the single-term search COVID-19 performed best in terms of precision (95.3%) and well in terms of sensitivity (94.4%) and F-score (94.8%). The term Wuhan virus performed the worst: 7.7% for sensitivity, 78.1% for precision, and 14.0% for F-score. We found that deleting a hyphen or space character could omit a substantial number of records, especially when searching with SARS-CoV-2 as a single term. CONCLUSIONS Comprehensive search strings combining free-text and indexed search terms performed better than single-term searches in PubMed, but not by a large margin compared to the single term COVID-19. For everyday searches, certain single-term searches that are entered correctly are probably sufficient, whereas more comprehensive searches should be used for systematic reviews. Still, we suggest additional measures that the US National Library of Medicine could take to support all PubMed users in searching the COVID-19 literature.
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Affiliation(s)
- Jeffrey V Lazarus
- Barcelona Institute for Global Health (ISGlobal), Hospital Clínic, University of Barcelona, Barcelona, Spain
| | - Adam Palayew
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, QC, Canada
| | | | - Tue Helms Andersen
- Danish Diabetes Knowledge Center, Steno Diabetes Center Copenhagen, Gentofte, Denmark
| | - Joey Nicholson
- NYU Langone Health, NYU Grossman School of Medicine, NYU Health Sciences Library, New York, NY, United States
| | - Ole Norgaard
- Danish Diabetes Knowledge Center, Steno Diabetes Center Copenhagen, Gentofte, Denmark
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