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Keogh RJ, Harvey H, Brady C, Hassett E, Costelloe SJ, O'Sullivan MJ, Twomey M, O'Leary MJ, Cahill MR, O'Riordan A, Joyce CM, Moloney G, Flavin A, M Bambury R, Murray D, Bennett K, Mullooly M, O'Reilly S. Dealing with digital paralysis: Surviving a cyberattack in a National Cancer center. J Cancer Policy 2024; 39:100466. [PMID: 38176467 DOI: 10.1016/j.jcpo.2023.100466] [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: 08/12/2023] [Revised: 11/26/2023] [Accepted: 12/21/2023] [Indexed: 01/06/2024]
Abstract
INTRODUCTION Cyberattacks represent a growing threat for healthcare delivery globally. We assess the impact and implications of a cyberattack on a cancer center in Ireland. METHODS On May 14th 2021 (day 0) Cork University Hospital (CUH) Cancer Center was involved in the first national healthcare ransomware attack in Ireland. Contingency plans were only present in laboratory services who had previously experienced information technology (IT) failures. No hospital cyberattack emergency plan was in place. Departmental logs of activity for 120 days after the attack were reviewed and compared with historical activity records. Daily sample deficits (routine daily number of samples analyzed - number of samples analyzed during cyberattack) were calculated. Categorical variables are reported as median and range. Qualitative data were collected via reflective essays and interviews with key stakeholders from affected departments in CUH. RESULTS On day 0, all IT systems were shut down. Radiotherapy (RT) treatment and cancer surgeries stopped, outpatient activity fell by 50%. hematology, biochemistry and radiology capacity fell by 90% (daily sample deficit (DSD) 2700 samples), 75% (DSD 2250 samples), and 90% (100% mammography/PET scan) respectively. Histopathology reporting times doubled (7 to 15 days). Radiotherapy (RT) was interrupted for 113 patients in CUH. The median treatment gap duration was six days for category 1 patients and 10 for the remaining patients. Partner organizations paused all IT links with CUH. Outsourcing of radiology and radiotherapy commenced, alternative communication networks and national conference calls in RT and Clinical Trials were established. By day 28 Email communication was restored. By day 210 reporting and data storage backlogs were cleared and over 2000 computers were checked/replaced. CONCLUSION Cyberattacks have rapid, profound and protracted impacts. While laboratory and diagnostic deficits were readily quantified, the impact of disrupted/delayed care on patient outcomes is less readily quantifiable. Cyberawareness and cyberattack plans need to be embedded in healthcare. POLICY SUMMARY Cyberattacks pose significant challenges for healthcare systems, impacting patient care, clinical outcomes, and staff wellbeing. This study provides a comprehensive review of the impact of the Conti ransomware attack on cancer services in Cork University Hospital (CUH), the first cyberattack on a national health service. Our study highlights the widespread disruption caused by a cyberattack including shutdown of information technology (IT) services, marked reduction in outpatient activity, temporary cessation of essential services such as radiation therapy. We provide a framework for other institutions for mitigating the impact of a cyberattack, underscoring the need for a cyberpreparedness plan similar to those made for natural disasters and the profound legacy of a cyberattack on patient care.
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Affiliation(s)
- Rachel J Keogh
- Department of Medical Oncology, Cork University Hospital, Wilton, Cork, Ireland; Cancer Research @UCC, College of Medicine and Health, University College Cork, Ireland.
| | - Harry Harvey
- Department of Medical Oncology, Cork University Hospital, Wilton, Cork, Ireland
| | - Claire Brady
- Department of Medical Oncology, Cork University Hospital, Wilton, Cork, Ireland; Cancer Research @UCC, College of Medicine and Health, University College Cork, Ireland; Cancer Trials Cork, Cork University Hospital, Ireland
| | - Edel Hassett
- Cancer Research @UCC, College of Medicine and Health, University College Cork, Ireland; Cancer Trials Cork, Cork University Hospital, Ireland
| | - Seán J Costelloe
- Department of Clinical Biochemistry, Cork University Hospital, Wilton, Cork, Ireland
| | - Martin J O'Sullivan
- Department of Breast Surgery, Cork University Hospital, Ireland; University College Cork, College Road, University College Cork, Ireland
| | - Maria Twomey
- Department of Radiology, Cork University Hospital, Ireland
| | - Mary Jane O'Leary
- Palliative Medicine, Marymount University Hospital and Hospice, Cork, Ireland; Palliative Medicine, Cork University Hospital, Ireland
| | - Mary R Cahill
- Department of Haematology, Cork University Hospital, Ireland
| | | | - Caroline M Joyce
- Department of Clinical Biochemistry, Cork University Hospital, Wilton, Cork, Ireland; INFANT Centre, University College Cork, Ireland; Pregnancy Loss Research Group, Department of Obstetrics & Gynaecology, University College Cork, University College Cork, Ireland
| | - Ger Moloney
- Information and Communication Technology (ICT) Department, Cork University Hospital, Ireland
| | - Aileen Flavin
- Bon Secours Radiotherapy Cork in Partnership with UPMC Hillman Cancer Centre, Cork, Ireland
| | - Richard M Bambury
- Department of Medical Oncology, Cork University Hospital, Wilton, Cork, Ireland; Cancer Research @UCC, College of Medicine and Health, University College Cork, Ireland; Cancer Trials Cork, Cork University Hospital, Ireland; Cancer Research @UCC, University College Cork, Cork, Ireland
| | | | - Kathleen Bennett
- School of Population Health, RCSI University of Medicine and Health Sciences Dublin, Ireland
| | - Maeve Mullooly
- School of Population Health, RCSI University of Medicine and Health Sciences Dublin, Ireland
| | - Seamus O'Reilly
- Department of Medical Oncology, Cork University Hospital, Wilton, Cork, Ireland; Cancer Research @UCC, College of Medicine and Health, University College Cork, Ireland; Cancer Trials Cork, Cork University Hospital, Ireland; Cancer Research @UCC, University College Cork, Cork, Ireland
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Bahrami MA, Tabari S, Tahmasebi S, Zangouri V, Ravangard R. Strategies to Promote Empowerment Status of Breast Cancer Women. Int J Breast Cancer 2024; 2024:3305399. [PMID: 38348180 PMCID: PMC10861285 DOI: 10.1155/2024/3305399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 01/01/2024] [Accepted: 01/25/2024] [Indexed: 02/15/2024] Open
Abstract
Background As the second leading cause of death in women in the world, breast cancer has several physical and psychological effects. Nowadays, nonclinical approaches such as patient empowerment have been considered by physicians along with clinical care. Given the increasing number of breast cancer women worldwide, promoting the empowerment of these patients is one of the key factors affecting their survival and quality of life. Therefore, because of no comprehensive research on the empowerment needs and related improvement strategies, this study is aimed at determining the empowerment status of breast cancer patients referred to the Shahid Motahari Breast Cancer Clinic in Iran, Shiraz, and at providing strategies to improve their empowerment in 2021. Methods This applied study was conducted in two phases. In the quantitative phase, 310 Cancer-Related Patient Empowerment Scale questionnaires (Persian format) were distributed among the studied patients selected through the random sampling method in the clinic, and the items with "unacceptable status" became the basis for determining the empowerment strategies through the scoping review and semistructured interviews with 22 medical staff and patients through the thematic analysis. The collected data were analyzed using the SPSS 20.0 and MAXQDA10 software. Results The mean score of the participants' empowerment strategies was 3.58. The results showed that trust in the physician, family support, and spiritual beliefs could affect the empowerment of the studied patients. Moreover, the participants needed empowerment strategies in 11 scale items with unacceptable status, for which 46 strategies were determined in the scoping review and interview phase. Conclusion The results of this study provided useful strategies for empowering breast cancer patients, the most important of which were classified into five categories of financial support, informational support, interaction with the physician, occupational support, and complementary therapies, the use of which by the stakeholders could help to improve the patients' quality of life while improving their empowerment.
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Affiliation(s)
- Mohammad Amin Bahrami
- Health Human Resources Research Center, Department of Health Services Management, School of Management and Medical Information Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Shahrzad Tabari
- Student Research Committee, Department of Health Services Management, School of Management and Medical Information Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Sedigheh Tahmasebi
- Breast Diseases Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Vahid Zangouri
- Breast Diseases Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ramin Ravangard
- Health Human Resources Research Center, Department of Health Services Management, School of Management and Medical Information Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
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Poliani A, Gnecchi S, Villa G, Rosa D, Manara DF. Gamification as an Educational Approach for Oncological Patients: A Systematic Scoping Review. Healthcare (Basel) 2023; 11:3116. [PMID: 38132006 PMCID: PMC10742971 DOI: 10.3390/healthcare11243116] [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: 09/23/2023] [Revised: 11/05/2023] [Accepted: 11/09/2023] [Indexed: 12/23/2023] Open
Abstract
BACKGROUND Education plays a pivotal role in the care of oncological patients, reducing health costs, hospital readmission, and disease relapses. Education can be supportive in achieving multiple outcomes, improving symptom control and quality of life. A new approach is emerging in patient education: gamification. Gamification was defined as the "use of game elements in non-game contexts", including the application of games in serious contexts. The aim of this review is to explore the use of gamification in the oncology setting. METHODS A systematic scoping review was conducted in the MEDLINE, CINAHL, PsychINFO, Embase, Scopus, and Cochrane Library databases using the JBI guidelines. RESULTS The 13 included reports were critically appraised by two reviewers independently. It seems that gamification could be effective both in prevention and cancer treatments. Gamification also seems to improve chemotherapy-induced nausea and vomiting management, quality of life, and reduced anxiety levels in different cancer groups. Moreover, gamification seems effective in improving self-care in cancer patients, regardless of gender, age, and ethnicity. CONCLUSIONS Gamification improves patient engagement and biopsychosocial outcomes and could represent a valid approach to cancer patient education; however, it is not a substitute for healthcare professionals, who remain the leaders in the education process.
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Affiliation(s)
- Andrea Poliani
- Center for Nursing Research and Innovation, Faculty of Medicine and Surgery, Vita-Salute San Raffaele University, 20132 Milan, Italy; (A.P.); (D.R.); (D.F.M.)
| | - Silvia Gnecchi
- IRCSS San Raffaele Scientific Institute, 20132 Milan, Italy;
| | - Giulia Villa
- Center for Nursing Research and Innovation, Faculty of Medicine and Surgery, Vita-Salute San Raffaele University, 20132 Milan, Italy; (A.P.); (D.R.); (D.F.M.)
| | - Debora Rosa
- Center for Nursing Research and Innovation, Faculty of Medicine and Surgery, Vita-Salute San Raffaele University, 20132 Milan, Italy; (A.P.); (D.R.); (D.F.M.)
| | - Duilio F. Manara
- Center for Nursing Research and Innovation, Faculty of Medicine and Surgery, Vita-Salute San Raffaele University, 20132 Milan, Italy; (A.P.); (D.R.); (D.F.M.)
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van Cappellen-van Maldegem SJM, Hoedjes M, Seidell JC, van de Poll-Franse LV, Buffart LM, Mols F, Beijer S. Self-performed Five Times Sit-To-Stand test at home as (pre-)screening tool for frailty in cancer survivors: Reliability and agreement assessment. J Clin Nurs 2023; 32:1370-1380. [PMID: 35332600 DOI: 10.1111/jocn.16299] [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: 12/09/2021] [Revised: 03/08/2022] [Accepted: 03/10/2022] [Indexed: 11/30/2022]
Abstract
AIMS AND OBJECTIVES The self-performance of a Five-Times-Sit-To-Stand (FTSTS)-test, without the usual supervision by a medical professional, provides valuable opportunities for clinical practice and research. This study aimed: (1) to determine the validity of the self-performed FTSTS test in comparison to a supervised reference test and (2) to determine the reliability of a self-performed FTSTS test by cancer survivors. BACKGROUND Early detection of frailty in cancer survivors may enable prehabilitation interventions before surgery or intensive treatment, improving cancer outcomes. DESIGN A repeated measures reliability and agreement study, with one week in between measures, was performed. METHODS Cancer survivors (n = 151) performed two FTSTS tests themselves. One additional reference FTSTS test was supervised by a physical therapist. The intraclass correlation coefficient (ICC), structural error of measurement (SEM) and minimally important clinical difference (MID) were calculated comparing a self-performed FTSTS test to the reference test, and comparing two self-performed FTSTS tests. The Guidelines for Reporting Reliability and Agreement Studies (GRASS) have been used. RESULTS Mean age of cancer survivors was 65.6 years (SD = 9.3), 54.6% were female, median time since diagnosis was 2 years [IQR = 1], and tumour type varied (e.g., breast cancer (31.8%), prostate cancer (17.2%), gastrointestinal cancer (11.9%) and haematological cancer (11.9%)). Validity of the self-performed FTSTS test at home was acceptable in comparison with the reference test (ICC = .74; SEM = 3.2; MID = 3.6) as was the reliability of the self-performed FTSTS test (ICC = .70; SEM = 2.2; MID = 3.8). CONCLUSIONS The self-performed FTSTS test is a valid and reliable measure to assess lower body function and has potential to be used as objective (pre-)screening tool for frailty in cancer survivors. RELEVANCE TO CLINICAL PRACTICE The self-performed FTSTS test at home may indicate the cancer survivors in need of prehabilitation in advance of surgery or intensive treatment. The feasibility, short amount of time needed and potential cost-effectiveness of the self-performed FTSTS test can make it a valuable contribution to personalised care and precision medicine.
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Affiliation(s)
- Sandra J M van Cappellen-van Maldegem
- Center of Research on Psychological and Somatic disorders, Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands
| | - Meeke Hoedjes
- Center of Research on Psychological and Somatic disorders, Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands
| | - Jacob C Seidell
- Department of Health Sciences, The EMGO+ Institute for Health and Care Research, VU University Amsterdam, Amsterdam, The Netherlands
| | - Lonneke V van de Poll-Franse
- Center of Research on Psychological and Somatic disorders, Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands.,Department of Research & Development, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands.,Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Laurien M Buffart
- Department of Physiology, Radboud Institute for Health Sciences, Radboudumc, Nijmegen, The Netherlands
| | - Floortje Mols
- Center of Research on Psychological and Somatic disorders, Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands.,Department of Research & Development, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands
| | - Sandra Beijer
- Department of Research & Development, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands
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Amiri P, Ahmadian L, Khajouei R. The applications and the effectiveness of mHealth interventions to manage lung cancer patients: a systematic review. HEALTH AND TECHNOLOGY 2023. [DOI: 10.1007/s12553-023-00735-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
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López B, Raya O, Baykova E, Saez M, Rigau D, Cunill R, Mayoral S, Carrion C, Serrano D, Castells X. APPRAISE-RS: Automated, updated, participatory, and personalized treatment recommender systems based on GRADE methodology. Heliyon 2023; 9:e13074. [PMID: 36798764 PMCID: PMC9925880 DOI: 10.1016/j.heliyon.2023.e13074] [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: 11/29/2022] [Revised: 01/04/2023] [Accepted: 01/16/2023] [Indexed: 01/26/2023] Open
Abstract
Purpose Clinical practice guidelines (CPGs) have become fundamental tools for evidence-based medicine (EBM). However, CPG suffer from several limitations, including obsolescence, lack of applicability to many patients, and limited patient participation. This paper presents APPRAISE-RS, which is a methodology that we developed to overcome these limitations by automating, extending, and iterating the methodology that is most commonly used for building CPGs: the GRADE methodology. Method APPRAISE-RS relies on updated information from clinical studies and adapts and automates the GRADE methodology to generate treatment recommendations. APPRAISE-RS provides personalized recommendations because they are based on the patient's individual characteristics. Moreover, both patients and clinicians express their personal preferences for treatment outcomes which are considered when making the recommendation (participatory). Rule-based system approaches are used to manage heuristic knowledge. Results APPRAISE-RS has been implemented for attention deficit hyperactivity disorder (ADHD) and tested experimentally on 28 simulated patients. The resulting recommender system (APPRAISE-RS/TDApp) shows a higher degree of treatment personalization and patient participation than CPGs, while recommending the most frequent interventions in the largest body of evidence in the literature (EBM). Moreover, a comparison of the results with four blinded psychiatrist prescriptions supports the validation of the proposal. Conclusions APPRAISE-RS is a valid methodology to build recommender systems that manage updated, personalized and participatory recommendations, which, in the case of ADHD includes at least one intervention that is identical or very similar to other drugs prescribed by psychiatrists.
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Affiliation(s)
- Beatriz López
- Control Engineering and Intelligent Systems (eXiT), University of Girona, Spain,Corresponding author.
| | - Oscar Raya
- Control Engineering and Intelligent Systems (eXiT), University of Girona, Spain
| | | | - Marc Saez
- Research Group on Statistics, Econometrics and Health, University of Girona, Spain,CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | | | - Ruth Cunill
- Sant Joan de Deu-Numancia Health Park, Barcelona, Spain
| | | | - Carme Carrion
- Health Lab Research Group, Universitat Oberta de Catalunya, Spain
| | | | - Xavier Castells
- TransLab Research Group, Dept. of Medical Sciences, University of Girona, Spain
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Rezaee R, Asadi S, Yazdani A, Rezvani A, Kazeroon AM. Development, usability and quality evaluation of the resilient mobile application for women with breast cancer. Health Sci Rep 2022; 5:e708. [PMID: 35782301 PMCID: PMC9234476 DOI: 10.1002/hsr2.708] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 05/30/2022] [Accepted: 06/08/2022] [Indexed: 12/15/2022] Open
Abstract
Introduction Mental health problems as a consequence of cancer lower the quality of life of cancer patients. Despite increasing studies of breast cancer‐focused mobile health applications (m‐Health apps), there is less research on breast cancer patients' quality of life or well‐being. The purpose of this study is to develop and evaluate the usability and quality of an educational m‐Health app aimed at improving the resilience of breast cancer in women. Methods This study was conducted in four phases. It included extracting the requirements of the app through the nominal group technique. Based on these results, an m‐Health app was developed and evaluated in terms of usability and quality by two scales, System Usability Scale and Mobile App Rating Scale questionnaires, respectively. Finally, the role of patients' age and educational backgrounds in the use of the app was assessed. The relationship between learnability and usability of the app was measured by the T‐Test. Results The app was developed with three user interfaces. Its usability developed from the patient's point of view scored a remarkable score of 83.20 with a 95% confidence interval. This value was too indicative of high satisfaction with the usefulness and the possibility of recommending it to other cancer survivors. The results of the quality evaluation from an expert's point of view showed that this app had good functionality. Evaluation of the role of demographic information in the use of the app showed that it can be used for all age groups with different levels of education. The app did not differ significantly between learnability and usability. Conclusion The development of m‐Health apps, based on usability principles that are suitable for all age groups with different levels of education, is welcomed by cancer patients.
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Affiliation(s)
- Rita Rezaee
- Department of Health Information Management, Clinical Education Research Center, Health Human Resources Research Center, School of Health Management and Information Sciences Shiraz University of Medical Sciences Shiraz Iran
| | - Sima Asadi
- Student Research Committee Shiraz University of Medical Sciences Shiraz Iran
| | - Azita Yazdani
- Department of Health Information Management, Clinical Education Research Center, Health Human Resources Research Center, School of Health Management and Information Sciences Shiraz University of Medical Sciences Shiraz Iran
| | - Alireza Rezvani
- Department of Internal Medicine, School of Medicine Shiraz University of Medical Sciences Shiraz Iran
| | - Arash Mani Kazeroon
- Department of Psychiatry, School of Medicine Shiraz University of Medical Sciences Shiraz Iran
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Gavaruzzi T. Where are we in shared decision-making in Italy? A brief updated review. ZEITSCHRIFT FUR EVIDENZ, FORTBILDUNG UND QUALITAT IM GESUNDHEITSWESEN 2022; 171:74-83. [PMID: 35618622 DOI: 10.1016/j.zefq.2022.05.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/03/2022] [Revised: 05/03/2022] [Accepted: 05/06/2022] [Indexed: 06/15/2023]
Abstract
The aim of this paper is to provide an overview of the current state of the art concerning patient-centred care (PCC), shared decision-making (SDM), and patient involvement in health care in Italy, by updating the previous versions of the review. In the past 5 years some progress has been made towards a higher involvement of patients in their health care and patient-centredness into the national health care system. The updated scoping literature search focused on articles reporting primary data collected in Italy and showed a great increase in the number of publications. Nonetheless, the research efforts are still relatively sporadic compared to other countries especially as for evaluations of interventions and, most notably, they are not driven by a consistent effort to promote SDM and PCC in clinical practice.
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Affiliation(s)
- Teresa Gavaruzzi
- Department of Developmental Psychology and Socialization, University of Padova, Italy.
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DeRosa AP, Grell Y, Razon D, Komsany A, Pinheiro LC, Martinez J, Phillips E. Decision-making support among racial and ethnic minorities diagnosed with breast or prostate cancer: A systematic review of the literature. PATIENT EDUCATION AND COUNSELING 2022; 105:1057-1065. [PMID: 34538465 DOI: 10.1016/j.pec.2021.09.012] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 06/01/2021] [Accepted: 09/06/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVE To describe the types of decision-making support interventions offered to racial and ethnic minority adults diagnosed with breast or prostate cancer and to draw any associations between these interventions and patient-reported quality of life (QoL) outcomes. METHODS We conducted literature searches in five bibliographic databases. Studies were screened through independent review and assessed for quality. Results were analyzed using inductive qualitative methods to determine thematic commonalities and synthesized in narrative form. RESULTS Searches across five databases yielded 2496 records, which were screened by title/abstract and full-text to identify 10 studies meeting inclusion criteria. The use of decision aids (DAs), trained personnel, delivery models and frameworks, and educational materials were notable decision-making support interventions. Analysis revealed six thematic areas: 1) Personalized reports; 2) Effective communication; 3) Involvement in decision-making; 4) Health literacy; 5) Social support; and 6) Feasibility in clinical setting. CONCLUSION Evidence suggests decision-making support interventions are associated with positive outcomes of racial and ethnic minorities with patient-reported factors like improved patient engagement, less decisional regret, higher satisfaction, improved communication, awareness of health literacy and cultural competence. PRACTICE IMPLICATIONS Future decision-making interventions for racial and ethnic minority cancer patients should focus on social determinants of health, social support systems, and clinical outcomes like QoL and survival.
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Affiliation(s)
- Antonio P DeRosa
- Samuel J. Wood Library & C.V. Starr Biomedical Information Center, Weill Cornell Medicine, New York, USA.
| | | | - Dominic Razon
- Division of General Internal Medicine, Weill Cornell Medicine, New York, USA
| | - Alia Komsany
- Department of Pathology and Laboratory Medicine, Weill Cornell Medicine, New York, USA
| | - Laura C Pinheiro
- Division of General Internal Medicine, Weill Cornell Medicine, New York, USA
| | - Juana Martinez
- Division of General Internal Medicine, Weill Cornell Medicine, New York, USA
| | - Erica Phillips
- Division of General Internal Medicine, Weill Cornell Medicine, New York, USA
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10
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Hamberger M, Ikonomi N, Schwab JD, Werle SD, Fürstberger A, Kestler AM, Holderried M, Kaisers UX, Steger F, Kestler HA. Interaction Empowerment in Mobile Health: Concepts, Challenges, and Perspectives. JMIR Mhealth Uhealth 2022; 10:e32696. [PMID: 35416786 PMCID: PMC9047725 DOI: 10.2196/32696] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Revised: 12/13/2021] [Accepted: 02/20/2022] [Indexed: 12/25/2022] Open
Abstract
In its most trending interpretation, empowerment in health care is implemented as a patient-centered approach. In the same sense, many mobile health (mHealth) apps are being developed with a primary focus on the individual user. The integration of mHealth apps into the health care system has the potential to counteract existing challenges, including incomplete or nonstandardized medical data and lack of communication, especially in the intersectional context (eg, patients, medical forces). However, concerns about data security and privacy, regional differences in regulations, lack of accessibility, and nontransparent apps hinder the successful integration of mHealth into the health care system. One approach to address this is to rethink the interpretation of empowerment. On that basis, we here examine existing approaches of individual empowerment and subsequently analyze a different view of empowerment in digital health, namely interaction empowerment. Such a change of perspective could positively influence intersectoral communication and facilitate secure data and knowledge sharing. We discuss this novel viewpoint on empowerment, focusing on more efficient integration and development of mHealth approaches. A renewed interpretation of empowerment could thus buffer current limitations of individual empowerment while also advancing digitization of the health system.
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Affiliation(s)
| | - Nensi Ikonomi
- Institute of Medical Systems Biology, Ulm University, Ulm, Germany
| | - Julian D Schwab
- Institute of Medical Systems Biology, Ulm University, Ulm, Germany
| | - Silke D Werle
- Institute of Medical Systems Biology, Ulm University, Ulm, Germany
| | - Axel Fürstberger
- Institute of Medical Systems Biology, Ulm University, Ulm, Germany
| | | | - Martin Holderried
- Department of Medical Development and Quality Management, University Hospital Tübingen, Tübingen, Germany
| | - Udo X Kaisers
- Chief Executive Officer, University Hospital Ulm, Ulm, Germany
| | - Florian Steger
- Institute of the History, Philosophy and Ethics of Medicine, Ulm University, Ulm, Germany
| | - Hans A Kestler
- Institute of Medical Systems Biology, Ulm University, Ulm, Germany
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Garani-Papadatos T, Natsiavas P, Meyerheim M, Hoffmann S, Karamanidou C, Payne SA. Ethical Principles in Digital Palliative Care for Children: The MyPal Project and Experiences Made in Designing a Trustworthy Approach. Front Digit Health 2022; 4:730430. [PMID: 35373180 PMCID: PMC8971573 DOI: 10.3389/fdgth.2022.730430] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Accepted: 02/03/2022] [Indexed: 12/31/2022] Open
Abstract
This paper explores the ethical dimension of the opportunity to offer improved electronic patient-reported outcome (ePRO) systems addressing personal needs of pediatric cancer patients, their parents and caregivers, with regard to technological advance of digital health. This opportunity has been explored in the MyPal research project, which aims to assess a patient-centered service for palliative care relying on the adaptation and extension of digital health tools and concepts available from previous projects. Development and implementation of ePROs need to take place in a safe, secure and responsible manner, preventing any possible harm and safeguarding the integrity of humans. To that end, although the final results will be published at the end of the project, this paper aims to increase awareness of the ethical ramifications we had to address in the design and testing of new technologies and to show the essentiality of protection and promotion of privacy, safety and ethical standards. We have thus reached a final design complying with the following principles: (a) respect for the autonomy of participants, especially children, (b) data protection and transparency, (c) fairness and non-discrimination, (d) individual wellbeing of participants in relation to their physical and psychological health status and e) accessibility and acceptability of digital health technologies for better user-engagement. These principles are adapted from the Ethics Guidelines for a trustworthy Artificial Intelligence (AI) which provide the framework for similar interventions to be lawful, complying with all applicable laws and regulations, ethical, ensuring compliance to ethical principles and values and robust, both from a technical and social perspective.
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Affiliation(s)
- Tina Garani-Papadatos
- Department of Public Health Policy, School of Public Health, University of West Attica, Athens, Greece
| | | | - Marcel Meyerheim
- Faculty of Medicine, Clinic of Pediatric Oncology and Hematology, Saarland University Hospital and Saarland University, Homburg, Germany
| | - Stefan Hoffmann
- Serious Games Solutions, a Division of Promotion Software GmbH, Tuebingen, Germany
| | | | - Sheila A Payne
- International Observatory on End of Life Care, Faculty of Health and Medicine, Lancaster University, Lancaster, United Kingdom
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12
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Developing an AI-Enabled Integrated Care Platform for Frailty. Healthcare (Basel) 2022; 10:healthcare10030443. [PMID: 35326921 PMCID: PMC8948747 DOI: 10.3390/healthcare10030443] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 02/18/2022] [Accepted: 02/23/2022] [Indexed: 12/04/2022] Open
Abstract
Informal care is considered to be important for the wellbeing and resilience of the elderly. However, solutions for the effective collaboration of healthcare professionals, patients, and informal caregivers are not yet widely available. The purpose of this paper is to present the development of a digital platform that uses innovative tools and artificial intelligence technologies to support care coordination and shared care planning for elder care, with a particular focus on frailty. The challenges of shared care planning in the coordination of frailty care are demonstrated, followed by presentation of the design and technical architecture of an integrated platform. The platform incorporates all elements essential for the support of daily activities, coordinated care, and timely interventions in case of emergency and need. This paper describes the challenges involved in implementing the platform and concludes by reporting the necessary steps required in order to establish effective smart care for the elderly.
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13
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Koumakis L, Schera F, Parker H, Bonotis P, Chatzimina M, Argyropaidas P, Zacharioudakis G, Schäfer M, Kakalou C, Karamanidou C, Didi J, Kazantzaki E, Scarfo L, Marias K, Natsiavas P. Fostering Palliative Care Through Digital Intervention: A Platform for Adult Patients With Hematologic Malignancies. Front Digit Health 2021; 3:730722. [PMID: 34977857 PMCID: PMC8718505 DOI: 10.3389/fdgth.2021.730722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Accepted: 11/16/2021] [Indexed: 11/13/2022] Open
Abstract
Patient-reported outcomes (PROs) are an emerging paradigm in clinical research and healthcare, aiming to capture the patient's self-assessed health status in order to gauge efficacy of treatment from their perspective. As these patient-generated health data provide insights into the effects of healthcare processes in real-life settings beyond the clinical setting, they can also be viewed as a resolution beyond what can be gleaned directly by the clinician. To this end, patients are identified as a key stakeholder of the healthcare decision making process, instead of passively following their doctor's guidance. As this joint decision-making process requires constant and high-quality communication between the patient and his/her healthcare providers, novel methodologies and tools have been proposed to promote richer and preemptive communication to facilitate earlier recognition of potential complications. To this end, as PROs can be used to quantify the patient impact (especially important for chronic conditions such as cancer), they can play a prominent role in providing patient-centric care. In this paper, we introduce the MyPal platform that aims to support adults suffering from hematologic malignancies, focusing on the technical design and highlighting the respective challenges. MyPal is a Horizon 2020 European project aiming to support palliative care for cancer patients via the electronic PROs (ePROs) paradigm, building upon modern eHealth technologies. To this end, MyPal project evaluate the proposed eHealth intervention via clinical studies and assess its potential impact on the provided palliative care. More specifically, MyPal platform provides specialized applications supporting the regular answering of well-defined and standardized questionnaires, spontaneous symptoms reporting, educational material provision, notifications etc. The presented platform has been validated by end-users and is currently in the phase of pilot testing in a clinical study to evaluate its feasibility and its potential impact on the quality of life of palliative care patients with hematologic malignancies.
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Affiliation(s)
- Lefteris Koumakis
- Institute of Computer Science, Foundation for Research and Technology–Hellas (FORTH), Heraklion, Greece
- *Correspondence: Lefteris Koumakis
| | - Fatima Schera
- Institute for Biomedical Engineering, Sulzbach, Germany
| | | | - Panos Bonotis
- Institute of Applied Biosciences, Centre for Research and Technology Hellas, Thessaloniki, Greece
| | - Maria Chatzimina
- Institute of Computer Science, Foundation for Research and Technology–Hellas (FORTH), Heraklion, Greece
| | - Panagiotis Argyropaidas
- Institute of Computer Science, Foundation for Research and Technology–Hellas (FORTH), Heraklion, Greece
| | - Giorgos Zacharioudakis
- Institute of Computer Science, Foundation for Research and Technology–Hellas (FORTH), Heraklion, Greece
| | | | - Christine Kakalou
- Institute of Applied Biosciences, Centre for Research and Technology Hellas, Thessaloniki, Greece
| | - Christina Karamanidou
- Institute of Applied Biosciences, Centre for Research and Technology Hellas, Thessaloniki, Greece
| | - Jana Didi
- Center for Molecular Medicine, Central European Institute of Technology, Masaryk University, Brno, Czechia
| | - Eleni Kazantzaki
- Department of Hematology, University Hospital of Heraklion, Heraklion, Greece
| | - Lydia Scarfo
- Universita Vita-Salute San Raffaele, Milan, Italy
| | - Kostas Marias
- Institute of Computer Science, Foundation for Research and Technology–Hellas (FORTH), Heraklion, Greece
| | - Pantelis Natsiavas
- Institute of Applied Biosciences, Centre for Research and Technology Hellas, Thessaloniki, Greece
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14
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Galli F, Scotto L, Ravenda S, Zampino MG, Pravettoni G, Mazzocco K. Personality Factors in Colorectal Cancer: A Systematic Review. Front Psychol 2021; 12:590320. [PMID: 34803785 PMCID: PMC8595914 DOI: 10.3389/fpsyg.2021.590320] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2020] [Accepted: 10/06/2021] [Indexed: 12/12/2022] Open
Abstract
Background: The role of personality in cancer incidence and development has been studied for a long time. As colorectal cancer (CRC) is one of the most prevalent cancer types and linked with lifestyle habits, it is important to better understand its psychological correlates, in order to design a more specific prevention and intervention plan. The aim of this systematic review is to analyze all the studies investigating the role of personality in CRC incidence. Methods: All studies on CRC and personality up to November 2020 were scrutinized according to the Cochrane Collaboration and the PRISMA statements. Selected studies were additionally evaluated for the Risk of Bias according to the Newcastle-Ottawa Scale (NOS). Results: Eight studies met the inclusion criteria and were eventually included in this review. Two main constructs have been identified as potential contributors of CRC incidence: emotional regulation (anger) and relational style (egoism). Conclusion: Strong conclusions regarding the influence of personality traits on the incidence of CRC are not possible, because of the small number and the heterogeneity of the selected studies. Further research is needed to understand the complexity of personality and its role in the incidence of CRC and the interaction with other valuable risk factors.
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Affiliation(s)
- Federica Galli
- Applied Research Division for Cognitive and Psychological Science, European Institute of Oncology, IRCCS, Milan, Italy.,Department of Dynamic and Clinical Psychology, and Health Studies, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy
| | - Ludovica Scotto
- Applied Research Division for Cognitive and Psychological Science, European Institute of Oncology, IRCCS, Milan, Italy
| | - Simona Ravenda
- Division of Gastrointestinal Medical Oncology and Neuroendocrine Tumors, European Institute of Oncology, IRCCS, Milan, Italy
| | - Maria Giulia Zampino
- Division of Gastrointestinal Medical Oncology and Neuroendocrine Tumors, European Institute of Oncology, IRCCS, Milan, Italy
| | - Gabriella Pravettoni
- Applied Research Division for Cognitive and Psychological Science, European Institute of Oncology, IRCCS, Milan, Italy.,Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | - Ketti Mazzocco
- Applied Research Division for Cognitive and Psychological Science, European Institute of Oncology, IRCCS, Milan, Italy.,Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
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15
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Abstract
Ontologies are widely used nowadays. However, the plethora of ontologies currently available online, makes it really difficult to identify which ontologies are appropriate for a given task and to decide on their quality characteristics. This is further complicated by the fact that multiple quality criteria have been proposed for ontologies, making it even more difficult to decide which ontology to adopt. In this context, in this paper we present Delta, a modular online tool for analyzing and evaluating ontologies. The interested user can upload an ontology to the tool, which then automatically analyzes it and graphically visualizes numerous statistics, metrics, and pitfalls. Those visuals presented include a diverse set of quality dimensions, further guiding users to understand the benefits and the drawbacks of each individual ontology and how to properly develop and extend it.
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16
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Moses JC, Adibi S, Shariful Islam SM, Wickramasinghe N, Nguyen L. Application of Smartphone Technologies in Disease Monitoring: A Systematic Review. Healthcare (Basel) 2021; 9:889. [PMID: 34356267 PMCID: PMC8303662 DOI: 10.3390/healthcare9070889] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 07/03/2021] [Accepted: 07/09/2021] [Indexed: 12/21/2022] Open
Abstract
Technologies play an essential role in monitoring, managing, and self-management of chronic diseases. Since chronic patients rely on life-long healthcare systems and the current COVID-19 pandemic has placed limits on hospital care, there is a need to explore disease monitoring and management technologies and examine their acceptance by chronic patients. We systematically examined the use of smartphone applications (apps) in chronic disease monitoring and management in databases, namely, Medline, Web of Science, Embase, and Proquest, published from 2010 to 2020. Results showed that app-based weight management programs had a significant effect on healthy eating and physical activity (p = 0.002), eating behaviours (p < 0.001) and dietary intake pattern (p < 0.001), decreased mean body weight (p = 0.008), mean Body Mass Index (BMI) (p = 0.002) and mean waist circumference (p < 0.001). App intervention assisted in decreasing the stress levels (paired t-test = 3.18; p < 0.05). Among cancer patients, we observed a high acceptance of technology (76%) and a moderately positive correlation between non-invasive electronic monitoring data and questionnaire (r = 0.6, p < 0.0001). We found a significant relationship between app use and standard clinical evaluation and high acceptance of the use of apps to monitor the disease. Our findings provide insights into critical issues, including technology acceptance along with regulatory guidelines to be considered when designing, developing, and deploying smartphone solutions targeted for chronic patients.
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Affiliation(s)
- Jeban Chandir Moses
- School of Information Technology, Deakin University, 1 Gheringhap St, Geelong, VIC 3220, Australia;
| | - Sasan Adibi
- School of Information Technology, Deakin University, 1 Gheringhap St, Geelong, VIC 3220, Australia;
| | | | - Nilmini Wickramasinghe
- Iverson Health Innovation Research Institute, Swinburne University of Technology, Hawthorn, VIC 3122, Australia;
| | - Lemai Nguyen
- Department of Information Systems and Business Analytics, Deakin Business School, 221 Burwood Highway, Burwood, VIC 3125, Australia;
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17
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Abstract
HIFUN is a high-level query language for expressing analytic queries of big datasets, offering a clear separation between the conceptual layer, where analytic queries are defined independently of the nature and location of data, and the physical layer, where queries are evaluated. In this paper, we present a methodology based on the HIFUN language, and the corresponding algorithms for the incremental evaluation of continuous queries. In essence, our approach is able to process the most recent data batch by exploiting already computed information, without requiring the evaluation of the query over the complete dataset. We present the generic algorithm which we translated to both SQL and MapReduce using SPARK; it implements various query rewriting methods. We demonstrate the effectiveness of our approach in temrs of query answering efficiency. Finally, we show that by exploiting the formal query rewriting methods of HIFUN, we can further reduce the computational cost, adding another layer of query optimization to our implementation.
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18
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Durosini I, Mazzocco K, Triberti S, Russo GA, Pravettoni G. Personality Traits and Cardiotoxicity Arising From Cancer Treatments: An Hypothesized Relationship. Front Psychol 2021; 12:546636. [PMID: 34025489 PMCID: PMC8132872 DOI: 10.3389/fpsyg.2021.546636] [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: 03/29/2020] [Accepted: 04/12/2021] [Indexed: 12/04/2022] Open
Abstract
Thanks to the evolution in medical and pharmaceutical research, to date, the number of cancer treatments is increasingly on the rise. Despite this, several side effects related to cancer treatments can exacerbate patients’ physical and psychological conditions, such as cardiotoxicity. Over the years, researchers have explored the possible relationship between psychological variables and physical diseases. Even though some authors examined the relationship between personality and specific diseases, no scientific attention has been paid to the role of personality in the development of cardiotoxicity arising from cancer treatments. Yet this is an important objective, given that determining whether personality influences cardiac toxicity of anticancer treatments could inform the processes by which stable psychological factors influence health. This contribution summarizes and analyzes the available scientific evidence about the association between personality and main cardiotoxicity-related-diseases of anticancer therapies, including cancer and cardiovascular diseases, in order to sketch a hypothetical model of the relationship between personality traits and cardiotoxicity.
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Affiliation(s)
- Ilaria Durosini
- Applied Research Division for Cognitive and Psychological Science, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Ketti Mazzocco
- Applied Research Division for Cognitive and Psychological Science, IEO, European Institute of Oncology IRCCS, Milan, Italy.,Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | - Stefano Triberti
- Applied Research Division for Cognitive and Psychological Science, IEO, European Institute of Oncology IRCCS, Milan, Italy.,Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | | | - Gabriella Pravettoni
- Applied Research Division for Cognitive and Psychological Science, IEO, European Institute of Oncology IRCCS, Milan, Italy.,Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
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19
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Kourou K, Manikis G, Poikonen-Saksela P, Mazzocco K, Pat-Horenczyk R, Sousa B, Oliveira-Maia AJ, Mattson J, Roziner I, Pettini G, Kondylakis H, Marias K, Karademas E, Simos P, Fotiadis DI. A machine learning-based pipeline for modeling medical, socio-demographic, lifestyle and self-reported psychological traits as predictors of mental health outcomes after breast cancer diagnosis: An initial effort to define resilience effects. Comput Biol Med 2021; 131:104266. [PMID: 33607379 DOI: 10.1016/j.compbiomed.2021.104266] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 02/01/2021] [Accepted: 02/09/2021] [Indexed: 12/19/2022]
Abstract
Displaying resilience following a diagnosis of breast cancer is crucial for successful adaptation to illness, well-being, and health outcomes. Several theoretical and computational models have been proposed toward understanding the complex process of illness adaptation, involving a large variety of patient sociodemographic, lifestyle, medical, and psychological characteristics. To date, conventional multivariate statistical methods have been used extensively to model resilience. In the present work we describe a computational pipeline designed to identify the most prominent predictors of mental health outcomes following breast cancer diagnosis. A machine learning framework was developed and tested on the baseline data (recorded immediately post diagnosis) from an ongoing prospective, multinational study. This fully annotated dataset includes socio-demographic, lifestyle, medical and self-reported psychological characteristics of women recently diagnosed with breast cancer (N = 609). Nine different feature selection and cross-validated classification schemes were compared on their performance in classifying patients into low vs high depression symptom severity. Best-performing approaches involved a meta-estimator combined with a Support Vector Machines (SVMs) classification algorithm, exhibiting balanced accuracy of 0.825, and a fair balance between sensitivity (90%) and specificity (74%). These models consistently identified a set of psychological traits (optimism, perceived ability to cope with trauma, resilience as trait, ability to comprehend the illness), and subjective perceptions of personal functionality (physical, social, cognitive) as key factors accounting for concurrent depression symptoms. A comprehensive supervised learning pipeline is proposed for the identification of predictors of depression symptoms which could severely impede adaptation to illness.
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Affiliation(s)
- Konstantina Kourou
- Unit of Medical Technology and Intelligent Information Systems, Department of Materials Science and Engineering, University of Ioannina, Ioannina, Greece; Foundation for Research and Technology-Hellas, Institute of Molecular Biology and Biotechnology, Department of Biomedical Research, Ioannina, Greece
| | - Georgios Manikis
- Computational Biomedicine Laboratory, FORTH-ICS, Heraklion, Greece
| | - Paula Poikonen-Saksela
- Helsinki University Hospital Comprehensive Cancer Center and Helsinki University, Finland
| | - Ketti Mazzocco
- Applied Research Division for Cognitive and Psychological Science, European Institute of Oncology, Milan, Italy; Department of Oncology and Hemato-oncology, University of Milan, Italy
| | - Ruth Pat-Horenczyk
- School of Social Work and Social Welfare,The Hebrew University of Jerusalem, Israel
| | - Berta Sousa
- Breast Unit, Champalimaud Clinical Centre/ Champalimaud Foundation, Champalimaud Research, Lisboa, Portugal
| | - Albino J Oliveira-Maia
- Champalimaud Research and Clinical Centre, Champalimaud Centre for the Unknown, Lisboa, Portugal; NOVA Medical School, NMS, Universidade Nova de Lisboa, Lisboa, Portugal
| | - Johanna Mattson
- Helsinki University Hospital Comprehensive Cancer Center and Helsinki University, Finland
| | - Ilan Roziner
- Department of Communication Disorders, Sackler Faculty of Medicine, Tel Aviv University, Israel
| | - Greta Pettini
- Applied Research Division for Cognitive and Psychological Science, European Institute of Oncology, Milan, Italy
| | | | - Kostas Marias
- Computational Biomedicine Laboratory, FORTH-ICS, Heraklion, Greece
| | - Evangelos Karademas
- Computational Biomedicine Laboratory, FORTH-ICS, Heraklion, Greece; Department of Psychology, University of Crete, Rethymno, Greece
| | - Panagiotis Simos
- Computational Biomedicine Laboratory, FORTH-ICS, Heraklion, Greece; School of Medicine, University of Crete, Heraklion, Greece
| | - Dimitrios I Fotiadis
- Unit of Medical Technology and Intelligent Information Systems, Department of Materials Science and Engineering, University of Ioannina, Ioannina, Greece; Foundation for Research and Technology-Hellas, Institute of Molecular Biology and Biotechnology, Department of Biomedical Research, Ioannina, Greece.
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20
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Graffigna G, Barello S, Savarese M, Palamenghi L, Castellini G, Bonanomi A, Lozza E. Measuring Italian citizens' engagement in the first wave of the COVID-19 pandemic containment measures: A cross-sectional study. PLoS One 2020; 15:e0238613. [PMID: 32915822 PMCID: PMC7485890 DOI: 10.1371/journal.pone.0238613] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Accepted: 08/20/2020] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND In January 2020, the coronavirus disease 2019 (COVID-19) started to spread in Italy. The Italian government adopted urgent measures to slow its spread. Enforcing compliance with such measures is crucial in order to enhance their effectiveness. Engaging citizens in the COVID-19 preventive process is urgent today both in Italy and around the world. However, to the best of our knowledge, no previous studies have investigated the role of health engagement in predicting citizens' compliance with health emergency containment measures. METHOD An online survey was administered between February 28 and March 4, 2020 on a representative sample of 1000 Italians. The questionnaire included a measure of health engagement (Patient Health Engagement Scale), a 5-item Likert scale ranging from 1 to 7, resulting in 4 positions that describe the psychological readiness to be active in one's own health management, and a series of ad hoc items intended to measure citizens' perceived susceptibility and severity of the disease, orientation towards health management, trust in institutional bodies, health habits and food consumption. To investigate the relationship between health engagement and these variables, ANOVA analysis, logistic regression and contingency tables with Pearson's chi-squared analysis have been carried out. RESULTS Less engaged people show higher levels of perceived susceptibility to the virus and severity of the disease; they are less trustful of scientific and healthcare authorities, they feel less self-effective in managing their own health-both in normal conditions and under stress-and are less prone to cooperate with healthcare professionals. Low levels of health engagement also are associated with a change in the usual purchase behavior. CONCLUSIONS The Patient Health Engagement model (PHE) provides a useful framework for understanding how people will respond to health threats such as pandemics. Therefore, intervention studies should focus on raising their levels of engagement to increase the effectiveness of educational initiatives intended to promote preventive behaviors.
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Affiliation(s)
- Guendalina Graffigna
- EngageMinds HUB–Consumer, Food & Health Engagement Research Center, Università Cattolica del Sacro Cuore, Milan, Italy
- Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy
- Faculty of Agricultural, Nutrition and Environmental Sciences, Università Cattolica del Sacro Cuore, Milan, Italy
| | - Serena Barello
- EngageMinds HUB–Consumer, Food & Health Engagement Research Center, Università Cattolica del Sacro Cuore, Milan, Italy
- Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy
| | - Mariarosaria Savarese
- EngageMinds HUB–Consumer, Food & Health Engagement Research Center, Università Cattolica del Sacro Cuore, Milan, Italy
- Faculty of Agricultural, Nutrition and Environmental Sciences, Università Cattolica del Sacro Cuore, Milan, Italy
| | - Lorenzo Palamenghi
- EngageMinds HUB–Consumer, Food & Health Engagement Research Center, Università Cattolica del Sacro Cuore, Milan, Italy
- Faculty of Agricultural, Nutrition and Environmental Sciences, Università Cattolica del Sacro Cuore, Milan, Italy
| | - Greta Castellini
- EngageMinds HUB–Consumer, Food & Health Engagement Research Center, Università Cattolica del Sacro Cuore, Milan, Italy
- Faculty of Agricultural, Nutrition and Environmental Sciences, Università Cattolica del Sacro Cuore, Milan, Italy
| | - Andrea Bonanomi
- Department of Statistical Science, Università Cattolica del Sacro Cuore, Milan, Italy
| | - Edoardo Lozza
- Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy
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21
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Letter to editor: the burden of covid-19 in neuro-oncological patients. J Neurooncol 2020; 148:399-400. [PMID: 32424574 PMCID: PMC7233193 DOI: 10.1007/s11060-020-03521-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Accepted: 04/25/2020] [Indexed: 10/27/2022]
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22
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Personally managed health data: Barriers, approaches and a roadmap for the future. J Biomed Inform 2020; 106:103440. [PMID: 32445857 DOI: 10.1016/j.jbi.2020.103440] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Accepted: 05/02/2020] [Indexed: 02/04/2023]
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23
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Fjell M, Langius-Eklöf A, Nilsson M, Wengström Y, Sundberg K. Reduced symptom burden with the support of an interactive app during neoadjuvant chemotherapy for breast cancer - A randomized controlled trial. Breast 2020; 51:85-93. [PMID: 32247251 PMCID: PMC7375618 DOI: 10.1016/j.breast.2020.03.004] [Citation(s) in RCA: 52] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Revised: 02/12/2020] [Accepted: 03/19/2020] [Indexed: 02/07/2023] Open
Abstract
Objectives Neoadjuvant chemotherapy causes distressing symptoms, which have to be managed by patients at home. Assessing and acting upon relevant patient-reported symptoms regularly with the support of mHealth such as apps, has shown to decrease symptom burden and improve health-related quality of life (HRQoL). There is a lack of apps for patients with breast cancer which are tested in rigorous trials and only a few include interactive components for immediate clinical management. The aim of this study was to evaluate whether the use of the interactive app Interaktor improves patients’ levels of symptom burden and HRQoL during neoadjuvant chemotherapy for breast cancer. Materials and methods This randomized controlled trial included patients in an intervention group (n = 74) and a control group (n = 75), recruited at two university hospitals in Stockholm, Sweden. The intervention group used Interaktor for symptom reporting, self-care advice and support from health-care professionals during treatment, and the control group received standard care alone. Self-reported symptoms and HRQoL were assessed at two time points to determine differences between the groups. Results The intervention group rated statistically significant less symptom prevalence in nausea, vomiting, feeling sad, appetite loss and constipation. Overall symptom distress and physical symptom distress were rated statistically significant lower in the intervention group. Further, emotional functioning was rated statistically significant higher in the intervention group. Conclusions By using the Interaktor app in clinical practice, patients get individual support when managing treatment-related symptoms during neoadjuvant chemotherapy for breast cancer, leading to decreased symptom burden and improved emotional functioning. Using the app Interaktor reduced symptom burden in patients with breast cancer. The use of Interaktor enhanced emotional functioning during treatment. Interaktor provided individual support during neoadjuvant chemotherapy. Use of Interaktor allowed breast cancer patients for daily reflection over symptoms.
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Affiliation(s)
- Maria Fjell
- Karolinska Institutet, Department of Neurobiology, Care Sciences and Society, Division of Nursing, Stockholm, Sweden.
| | - Ann Langius-Eklöf
- Karolinska Institutet, Department of Neurobiology, Care Sciences and Society, Division of Nursing, Stockholm, Sweden
| | - Marie Nilsson
- Karolinska Institutet, Department of Neurobiology, Care Sciences and Society, Division of Nursing, Stockholm, Sweden; Karolinska University Hospital, Function Area Social Work in Health Care, Stockholm, Sweden; Stockholm County Council, Academic Primary Health Care Center, Stockholm, Sweden
| | - Yvonne Wengström
- Karolinska Institutet, Department of Neurobiology, Care Sciences and Society, Division of Nursing, Stockholm, Sweden; Karolinska University Hospital, Cancer Theme, Stockholm, Sweden
| | - Kay Sundberg
- Karolinska Institutet, Department of Neurobiology, Care Sciences and Society, Division of Nursing, Stockholm, Sweden
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24
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Abstract
Providing useful resources to patients is essential in achieving the vision of participatory medicine. However, the problem of identifying pertinent content for a group of patients is even more difficult than identifying information for just one. Nevertheless, studies suggest that the group dynamics-based principles of behavior change have a positive effect on the patients’ welfare. Along these lines, in this paper, we present a multidimensional recommendation model in the health domain using collaborative filtering. We propose a novel semantic similarity function between users, going beyond patient medical problems, considering additional dimensions such as the education level, the health literacy, and the psycho-emotional status of the patients. Exploiting those dimensions, we are interested in providing recommendations that are both high relevant and fair to groups of patients. Consequently, we introduce the notion of fairness and we present a new aggregation method, accumulating preference scores. We experimentally show that our approach can perform better recommendations to small group of patients for useful information documents.
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