Informatics and e-health: advancing knowledge and improving cancer care

Collaborative e-Health Environments: The enhanced role of health agents

Abstract The literature has discussed the importance of the impact of Information and Communication Technology on health promotion, health education and applications to promote change in health behaviors, denominated e-Health promotion. The objective of this article is to describe Web 2.0 properties that should converge to a peer-to-peer collaboration platform, with the mediation of a health agent. This Web 2.0 system should provide a space where people may, not only receive information, but also exchange ideas and experiences about how to deal with the conditions resulting from the diseases caused by Zika virus, such as microcephaly. Microcephaly is a rare neurological condition in which the child’s head and brain are significantly smaller than those of others at the same age and sex and may cause a number of genetic or environmental problems. The risk of a Zika epidemic is real, it mainly affects people in poor countries, and especially Brazil that has the social responsibility to face the challenge of supporting hundreds of families of children born with microcephaly. E-Health projects are often focused only on health service managers, practitioners and research partners. These projects are not of open access and, in Brazil, there is no public platform that serves non-specialized citizens. We suggest a design that includes the health worker, family and stakeholders as content creators, able to act peer-to-peer and bottom-up, which may be useful for developing countries with similar health contexts.

Fighting Global Disparities in Cancer Care: A Surgical Oncology View

Cancer is the second leading cause of death globally after cardiovascular disease. Long-term cancer survival has improved in the Western world due to early detection and the use of effective combined treatment modalities, as well as the development of effective immunotherapy and drug-targeted therapy. Surgery is still the mainstay for most solid tumors; however, low- and middle-income countries are facing an increasing lack of primary surgical care for easily treatable conditions, including breast, colon, and head and neck cancers. In this paper, a surgical oncology view is presented to elaborate how the Western surgical oncologist can take part in the ‘surgical fight’ against global disparities in cancer care, and a plea is made to strive for structural solutions, such as a partnership in surgical oncology training. The pros and cons of the use of eHealth and mHealth technologies and education programs for schools and the community are discussed as these create an opportunity to reach a large portion of the population in these countries, at low cost and with high impact.

Patient preference: a comparison of electronic patient-completed questionnaires with paper among cancer patients

In this study, we compared cancer patients preference for computerised (tablet/web-based) surveys versus paper. We also assessed whether the understanding of a cancer-related topic, pharmacogenomics is affected by the survey format, and examined differences in demographic and medical characteristics which may affect patient preference and understanding. Three hundred and four cancer patients completed a tablet-administered survey and another 153 patients completed a paper-based survey. Patients who participated in the tablet survey were questioned regarding their preference for survey format administration (paper, tablet and web-based). Understanding was assessed with a 'direct' method, by asking patients to assess their understanding of genetic testing, and with a 'composite' score. Patients preferred administration with tablet (71%) compared with web-based (12%) and paper (17%). Patients <65 years old, non-Caucasians and white-collar professionals significantly preferred the computerised format following multivariate analysis. There was no significant difference in understanding between the paper and tablet survey with direct questioning or composite score. Age (<65 years) and white-collar professionals were associated with increased understanding (both P = 0.03). There was no significant difference in understanding between the tablet and print survey in a multivariate analysis. Patients overwhelmingly preferred computerised surveys and understanding of pharmacogenomics was not affected by survey format.