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Saheb T, Saheb T. Digital health policy decoded: Mapping national strategies using Donabedian's model. Health Policy 2024; 147:105134. [PMID: 39053416 DOI: 10.1016/j.healthpol.2024.105134] [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: 01/18/2024] [Revised: 07/05/2024] [Accepted: 07/11/2024] [Indexed: 07/27/2024]
Abstract
National strategies are essential driving forces behind governments taking responsibility for setting the direction of digital health on a national level. This study employed a novel mixed-methods approach, integrating topic modeling, co-occurrence analysis, and qualitative content analysis, to comprehensively examine 22 national digital health strategies through the lens of Donabedian's structure-process-outcome model. The quantitative analysis identified 14 prevalent topics, while the qualitative analysis provided nuanced insights into the contexts underlying these topics. Leveraging Donabedian's framework, the topics were categorized into structure (training and digital health professionals, governance frameworks, computing infrastructure, public-private partnerships, regulatory frameworks), process (AI and big data, decision-support systems, shared digital health records, disease surveillance, information system interoperability), and outcome dimensions (improved health and social care, privacy and security, quality and efficiency of health services, universal coverage, sustainable development goals). This hybrid methodology offers a unique contribution by mapping the identified themes onto a widely accepted quality of care model, bridging the gap between policy analysis and healthcare quality assessment. The study unveils underaddressed themes, highlights the interrelationships between policy components, and provides a comprehensive understanding of the global digital health policy landscape. The findings inform future strategies, academic research directions, and potential policy considerations for governments formulating digital health regulations.
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Affiliation(s)
- Tahereh Saheb
- Menlo College, 1000 El Camino Real, Atherton, CA 94027, USA.
| | - Tayebeh Saheb
- Faculty of Law, Tarbiat Modares University, Tehran, Iran
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2
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Baker SR, Heaton LJ, McGrath C. Evolution and development of methodologies in social and behavioural science research in relation to oral health. Community Dent Oral Epidemiol 2023; 51:46-57. [PMID: 36756884 DOI: 10.1111/cdoe.12821] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 11/08/2022] [Accepted: 11/15/2022] [Indexed: 02/10/2023]
Abstract
The aim of this introductory paper is to provide an overview of key methodological developments in social and behavioural research in oral health. In the first section, we provide a brief historical perspective on research in the field. In the second section, we outline key methodological issues and introduce the seven papers in the theme. Conceptual models can contextualize research findings and address the 'why' and 'how' instead of 'what' and 'how many'. Many models exist, albeit they need to be evaluated (and adapted) for use in oral health research and in specific settings. The increasing availability of big data can facilitate this with data linkage. Through data linkage, it is possible to explore and understand in a broader capacity the array of factors that influence oral health outcomes and how oral health can influences other factors. With advances in statistical approaches, it is feasible to consider casual inferences and to quantify these effects. There is a need for not only individual efforts to embrace causal inference research but also systematic and structural changes in the field to yield substantial results. The value of qualitative research in co-producing knowledge with and from human participants in addressing 'the how' and 'the why' factors is also key. There have been calls to employ more sophisticated qualitative methods together with mixed methods approaches as ways of helping to address the complex or Wicked Problems in population oral health. In the final section, we outline possible future methodological directions in social and behavioural oral health research including participatory approaches and the development of core outcome sets. Our overriding goal in the paper is to facilitate a critical debate in relation to methodological issues which can be used to improve understanding and generate knowledge in population oral health and that this, in turn, will help inform oral health policy and practices.
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Affiliation(s)
- Sarah R Baker
- Unit of Oral Health, Dentistry and Society, School of Clinical Dentistry, University of Sheffield, Sheffield, UK
| | - Lisa J Heaton
- CareQuest Institute for Oral Health, Boston, Massachusetts, USA.,Department of Oral Health Sciences, University of Washington School of Dentistry, Seattle, Washington, USA
| | - Colman McGrath
- Applied Oral Sciences & Community Dental Care, The University of Hong Kong, Hong Kong, Hong Kong
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3
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Abstract
Our world is at a turning point with biological and social pathogens wreaking havoc at the same time that science and technology are exploding with new discoveries. It is a pivotal time for the new report Oral Health in America: Advances and Challenges to be released and a pivotal time for our profession to take action and lead. The art, science, and practice of dentistry is very different from 20 y ago when the original Surgeon General's report was released. We are on the precipice of individualized health care where providers will collaborate to deliver diagnostics and therapeutics that are data driven and inclusive of the social determinants of health. To move forward with alacrity requires a strong scientific foundation, effective educational approaches, an understanding of the upstream determinants of health, and partnerships across the health professions and beyond. Oral health has never been more important, and now is the time for our profession to further develop, elevate, and translate the science into practice and policy to improve the nation's health.
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Affiliation(s)
- L K McCauley
- School of Dentistry, University of Michigan, Ann Arbor, MI, USA
| | - M Robinson
- School of Dentistry, University of Alabama at Birmingham, Birmingham, AL, USA
| | - R N D'Souza
- National Institutes of Health, National Institute of Dental and Craniofacial Research, Bethesda, MD, USA
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4
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Bartold PM, Ivanovski S. P4 Medicine as a model for precision periodontal care. Clin Oral Investig 2022; 26:5517-5533. [PMID: 35344104 PMCID: PMC9474478 DOI: 10.1007/s00784-022-04469-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Accepted: 03/17/2022] [Indexed: 12/15/2022]
Abstract
Objectives P4 Medicine is based on a proactive approach for clinical patient care incorporating the four “pillars” of prediction, prevention, personalization, and participation for patient management. The purpose of this review is to demonstrate how the concepts of P4 medicine can be incorporated into the management of periodontal diseases (particularly periodontitis) termed P4 periodontics. Methods This is a narrative review that used current literature to explore how P4 periodontics can be aligned with the 2018 Classification of Periodontal Diseases, current periodontal treatment paradigms, and periodontal regenerative technologies. Results The proposed model of P4 periodontics is highly aligned with the 2018 Classification of Periodontal Diseases and represents a logical extension of this classification into treatment paradigms. Each stage of periodontitis can be related to a holistic approach to clinical management. The role of “big data” in future P4 periodontics is discussed and the concepts of a treat-to-target focus for treatment outcomes are proposed as part of personalized periodontics. Personalized regenerative and rejuvenative periodontal therapies will refocus our thinking from risk management to regenerative solutions to manage the effects of disease and aging. Conclusions P4 Periodontics allows us to focus not only on early prevention and intervention but also allow for personalized late-stage reversal of the disease trajectory and the use of personalized regenerative procedures to reconstruct damaged tissues and restore them to health. Clinical Significance P4 Periodontics is a novel means of viewing a holistic, integrative, and proactive approach to periodontal treatment.
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Affiliation(s)
- P Mark Bartold
- University of Queensland, 1 Milton Avenue, Beaumont, South Australia, 5066, Australia.
| | - Sašo Ivanovski
- University of Queensland, 1 Milton Avenue, Beaumont, South Australia, 5066, Australia
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5
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Jayaweera M, Amarasinghe H, Johnson NW. Reshaping dental practice in the face of the COVID-19 pandemic: Leapfrogging to Dentronics. Oral Dis 2021; 28 Suppl 2:2556-2558. [PMID: 34676947 PMCID: PMC8661861 DOI: 10.1111/odi.14043] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 10/02/2021] [Accepted: 10/04/2021] [Indexed: 11/26/2022]
Affiliation(s)
- Mahesh Jayaweera
- Department of Civil Engineering, University of Moratuwa, Moratuwa, Sri Lanka
| | - Hemantha Amarasinghe
- Training unit, Institute of Oral Health, Maharagama, Sri Lanka.,Menzies Heath Institute Queensland, Griffith University, Gold Coast, Queensland, Australia
| | - Newell W Johnson
- Menzies Heath Institute Queensland, Griffith University, Gold Coast, Queensland, Australia.,Faculty of Dentistry and Craniofacial Sciences, King's College London, London, UK
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6
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Al Turkestani N, Bianchi J, Deleat-Besson R, Le C, Tengfei L, Prieto JC, Gurgel M, Ruellas ACO, Massaro C, Aliaga Del Castillo A, Evangelista K, Yatabe M, Benavides E, Soki F, Zhang W, Najarian K, Gryak J, Styner M, Fillion-Robin JC, Paniagua B, Soroushmehr R, Cevidanes LHS. Clinical decision support systems in orthodontics: A narrative review of data science approaches. Orthod Craniofac Res 2021; 24 Suppl 2:26-36. [PMID: 33973362 DOI: 10.1111/ocr.12492] [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: 03/14/2021] [Revised: 04/15/2021] [Accepted: 05/04/2021] [Indexed: 12/27/2022]
Abstract
Advancements in technology and data collection generated immense amounts of information from various sources such as health records, clinical examination, imaging, medical devices, as well as experimental and biological data. Proper management and analysis of these data via high-end computing solutions, artificial intelligence and machine learning approaches can assist in extracting meaningful information that enhances population health and well-being. Furthermore, the extracted knowledge can provide new avenues for modern healthcare delivery via clinical decision support systems. This manuscript presents a narrative review of data science approaches for clinical decision support systems in orthodontics. We describe the fundamental components of data science approaches including (a) Data collection, storage and management; (b) Data processing; (c) In-depth data analysis; and (d) Data communication. Then, we introduce a web-based data management platform, the Data Storage for Computation and Integration, for temporomandibular joint and dental clinical decision support systems.
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Affiliation(s)
- Najla Al Turkestani
- Department of Orthodontics and Pediatric Dentistry, University of Michigan School of Dentistry, Ann Arbor, MI, USA.,Department of Restorative and Aesthetic Dentistry, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Jonas Bianchi
- Department of Orthodontics and Pediatric Dentistry, University of Michigan School of Dentistry, Ann Arbor, MI, USA.,Department of Orthodontics, Arthur A. Dugoni School of Dentistry, University of the Pacific, San Francisco, CA, USA
| | - Romain Deleat-Besson
- Department of Orthodontics and Pediatric Dentistry, University of Michigan School of Dentistry, Ann Arbor, MI, USA
| | - Celia Le
- Department of Orthodontics and Pediatric Dentistry, University of Michigan School of Dentistry, Ann Arbor, MI, USA
| | - Li Tengfei
- Department of Biostatistics, University of North Carolina, Chapel Hill, NC, USA
| | - Juan Carlos Prieto
- Department of Psychiatry, University of North Carolina, Chapel Hill, NC, USA
| | - Marcela Gurgel
- Department of Orthodontics and Pediatric Dentistry, University of Michigan School of Dentistry, Ann Arbor, MI, USA
| | - Antonio C O Ruellas
- Department of Orthodontics and Pediatric Dentistry, University of Michigan School of Dentistry, Ann Arbor, MI, USA.,Department of Orthodontics, School of Dentistry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Camila Massaro
- Department of Orthodontics and Pediatric Dentistry, University of Michigan School of Dentistry, Ann Arbor, MI, USA.,Department of Orthodontics, Bauru Dental School, University of São Paulo, São Paulo, Brazil
| | - Aron Aliaga Del Castillo
- Department of Orthodontics and Pediatric Dentistry, University of Michigan School of Dentistry, Ann Arbor, MI, USA.,Department of Orthodontics, Bauru Dental School, University of São Paulo, São Paulo, Brazil
| | - Karine Evangelista
- Department of Orthodontics and Pediatric Dentistry, University of Michigan School of Dentistry, Ann Arbor, MI, USA.,Department of Orthodontics, School of Dentistry, University of Goias, Goiania, Brazil
| | - Marilia Yatabe
- Department of Orthodontics and Pediatric Dentistry, University of Michigan School of Dentistry, Ann Arbor, MI, USA
| | - Erika Benavides
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, USA
| | - Fabiana Soki
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, USA
| | - Winston Zhang
- Department of Computational Medicine and Bioinformatics, University of Michigan, Ann Arbor, MI, USA
| | - Kayvan Najarian
- Department of Computational Medicine and Bioinformatics, University of Michigan, Ann Arbor, MI, USA
| | - Jonathan Gryak
- Department of Computational Medicine and Bioinformatics, University of Michigan, Ann Arbor, MI, USA
| | - Martin Styner
- Departments Psychiatry and Computer Science, University of North Carolina, Chapel Hill, NC, USA
| | | | | | - Reza Soroushmehr
- Department of Computational Medicine and Bioinformatics, University of Michigan, Ann Arbor, MI, USA
| | - Lucia H S Cevidanes
- Department of Orthodontics and Pediatric Dentistry, University of Michigan School of Dentistry, Ann Arbor, MI, USA
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Alauddin MS, Baharuddin AS, Mohd Ghazali MI. The Modern and Digital Transformation of Oral Health Care: A Mini Review. Healthcare (Basel) 2021; 9:healthcare9020118. [PMID: 33503807 PMCID: PMC7912705 DOI: 10.3390/healthcare9020118] [Citation(s) in RCA: 43] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Revised: 12/31/2020] [Accepted: 01/12/2021] [Indexed: 12/13/2022] Open
Abstract
Dentistry is a part of the field of medicine which is advocated in this digital revolution. The increasing trend in dentistry digitalization has led to the advancement in computer-derived data processing and manufacturing. This progress has been exponentially supported by the Internet of medical things (IoMT), big data and analytical algorithm, internet and communication technologies (ICT) including digital social media, augmented and virtual reality (AR and VR), and artificial intelligence (AI). The interplay between these sophisticated digital aspects has dramatically changed the healthcare and biomedical sectors, especially for dentistry. This myriad of applications of technologies will not only be able to streamline oral health care, facilitate workflow, increase oral health at a fraction of the current conventional cost, relieve dentist and dental auxiliary staff from routine and laborious tasks, but also ignite participatory in personalized oral health care. This narrative article review highlights recent dentistry digitalization encompassing technological advancement, limitations, challenges, and conceptual theoretical modern approaches in oral health prevention and care, particularly in ensuring the quality, efficiency, and strategic dental care in the modern era of dentistry.
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Affiliation(s)
- Muhammad Syafiq Alauddin
- Department of Conservative Dentistry and Prosthodontics, Faculty of Dentistry, Universiti Sains Islam Malaysia, Kuala Lumpur 56100, Malaysia
- Correspondence:
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Liu YCG, Lan SJ, Hirano H, Lin LM, Hori K, Lin CS, Zwetchkenbaum S, Minakuchi S, Teng AYT. Update and review of the gerodontology prospective for 2020's: Linking the interactions of oral (hypo)-functions to health vs. systemic diseases. J Dent Sci 2020; 16:757-773. [PMID: 33854730 PMCID: PMC8025188 DOI: 10.1016/j.jds.2020.09.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Revised: 09/03/2020] [Indexed: 02/07/2023] Open
Abstract
New lines of evidence suggest that the oral-systemic medical links and oral hypo-function are progressively transcending beyond the traditional clinical signs and symptoms of oral diseases. Research into the dysbiotic microbiome, host immune/inflammatory regulations and patho-physiologic changes and subsequent adaptations through the oral-systemic measures under ageism points to pathways leading to mastication deficiency, dysphagia, signature brain activities for (neuro)-cognition circuitries, dementia and certain cancers of the digestive system as well. Therefore, the coming era of oral health-linked systemic disorders will likely reshape the future of diagnostics in oral geriatrics, treatment modalities and professional therapies in clinical disciplines. In parallel to these highlights, a recent international symposium was jointly held by the International Association of Gerontology and Geriatrics (IAGG), Japanese Society of Gerodontology (JSG), the representative of USA and Taiwan Academy of Geriatric Dentistry (TAGD) on Oct 25th, 2019. Herein, specific notes are briefly addressed and updated for a summative prospective from this symposium and the recent literature.
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Affiliation(s)
- Yen Chun G. Liu
- Center for Osteoimmunology & Biotechnology Research (COBR) and Dept. of Oral Hygiene, College of Dental Medicine, Kaohsiung Medical University (KMU), Kaohsiung, Taiwan
- Corresponding author. Dept. of Oral Hygiene & COBR, College of Dental Medicine, Kaohsiung Medical University; No. 100, Shih-Chun 1st Rd, Kaohsiung 807, Taiwan. Fax: +886 07 3223141.
| | - Shou-Jen Lan
- Dept. of Healthcare Administration, Asia University, Tai-Chung, Taiwan
| | - Hirohiko Hirano
- Research Team for Promoting Independence & Mental Health, and Dentistry & Oral Surgery, Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology, Tokyo, Japan
| | - Li-min Lin
- Div. of Oral Pathology & Oral Maxillo-facial Radiology, School of Dentistry, Kaohsiung Medical University & KMU-Hospital, Kaohsiung, Taiwan
| | - Kazuhiro Hori
- Div. of Comprehensive Prosthodontics, Faculty of Dentistry & Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
| | - Chia-shu Lin
- Dept. of Dentistry, School of Dentistry, National Yang-Ming University, Taipei, Taiwan
| | - Samuel Zwetchkenbaum
- Rhode Island Dept. of Health, Rhode Island, USA
- School of Public Health, Brown University, Providence, RI, USA
| | - Shunsuke Minakuchi
- Gerodontology & Oral Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Andy Yen-Tung Teng
- Center for Osteoimmunology & Biotechnology Research (COBR) and Dept. of Oral Hygiene, College of Dental Medicine, Kaohsiung Medical University (KMU), Kaohsiung, Taiwan
- Center for Osteoimmunology & Biotechnology Research (COBR) and School of Dentistry, College of Dental Medicine, Kaohsiung Medical University and KMU-Hospital, Kaohsiung, Taiwan
- Corresponding author. Center for Osteoimmunology and Biotechnology Research (COBR), College of Dental Medicine, Kaohsiung Medical University (KMU) & KMU-Hospital, Kaohsiung, Taiwan.
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9
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Pereira JAM, Porto-Figueira P, Taware R, Sukul P, Rapole S, Câmara JS. Unravelling the Potential of Salivary Volatile Metabolites in Oral Diseases. A Review. Molecules 2020; 25:E3098. [PMID: 32646009 PMCID: PMC7412334 DOI: 10.3390/molecules25133098] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 07/02/2020] [Accepted: 07/06/2020] [Indexed: 12/24/2022] Open
Abstract
Fostered by the advances in the instrumental and analytical fields, in recent years the analysis of volatile organic compounds (VOCs) has emerged as a new frontier in medical diagnostics. VOCs analysis is a non-invasive, rapid and inexpensive strategy with promising potential in clinical diagnostic procedures. Since cellular metabolism is altered by diseases, the resulting metabolic effects on VOCs may serve as biomarkers for any given pathophysiologic condition. Human VOCs are released from biomatrices such as saliva, urine, skin emanations and exhaled breath and are derived from many metabolic pathways. In this review, the potential of VOCs present in saliva will be explored as a monitoring tool for several oral diseases, including gingivitis and periodontal disease, dental caries, and oral cancer. Moreover, the analytical state-of-the-art for salivary volatomics, e.g., the most common extraction techniques along with the current challenges and future perspectives will be addressed unequivocally.
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Affiliation(s)
- Jorge A. M. Pereira
- CQM–Centro de Química da Madeira, Universidade da Madeira, Campus da Penteada, 9020-105 Funchal, Portugal;
| | - Priscilla Porto-Figueira
- CQM–Centro de Química da Madeira, Universidade da Madeira, Campus da Penteada, 9020-105 Funchal, Portugal;
| | - Ravindra Taware
- Proteomics Lab, National Centre for Cell Science (NCCS), Ganeshkhind Road, SPPU Campus, Pune 411007, India; (R.T.); (S.R.)
| | - Pritam Sukul
- Department of Anaesthesiology and Intensive Care Medicine, Rostock Medical Breath Research Analytics and Technologies (ROMBAT), Rostock University Medical Centre, 18057 Rostock, Germany;
| | - Srikanth Rapole
- Proteomics Lab, National Centre for Cell Science (NCCS), Ganeshkhind Road, SPPU Campus, Pune 411007, India; (R.T.); (S.R.)
| | - José S. Câmara
- CQM–Centro de Química da Madeira, Universidade da Madeira, Campus da Penteada, 9020-105 Funchal, Portugal;
- Faculdade de Ciências Exatas e da Engenharia, Universidade da Madeira, Campus da Penteada, 9020-105 Funchal, Portugal
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10
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Finkelstein J, Zhang F, Levitin SA, Cappelli D. Using big data to promote precision oral health in the context of a learning healthcare system. J Public Health Dent 2020; 80 Suppl 1:S43-S58. [PMID: 31905246 PMCID: PMC7078874 DOI: 10.1111/jphd.12354] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2019] [Revised: 10/08/2019] [Accepted: 12/02/2019] [Indexed: 12/31/2022]
Abstract
There has been a call for evidence-based oral healthcare guidelines, to improve precision dentistry and oral healthcare delivery. The main challenges to this goal are the current lack of up-to-date evidence, the limited integrative analytical data sets, and the slow translations to routine care delivery. Overcoming these issues requires knowledge discovery pipelines based on big data and health analytics, intelligent integrative informatics approaches, and learning health systems. This article examines how this can be accomplished by utilizing big data. These data can be gathered from four major streams: patients, clinical data, biological data, and normative data sets. All these must then be uniformly combined for analysis and modelling and the meaningful findings can be implemented clinically. By executing data capture cycles and integrating the subsequent findings, practitioners are able to improve public oral health and care delivery.
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Affiliation(s)
- Joseph Finkelstein
- Department of Population Health Science and PolicyIcahn School of Medicine at Mount SinaiNew YorkNYUSA
| | - Frederick Zhang
- Center for Bioinformatics and Data Analytics in Oral HealthCollege of Dental Medicine, Columbia UniversityNew YorkNYUSA
| | - Seth A. Levitin
- Center for Bioinformatics and Data Analytics in Oral HealthCollege of Dental Medicine, Columbia UniversityNew YorkNYUSA
| | - David Cappelli
- Department of Biomedical SciencesSchool of Dental Medicine, University of NevadaLas VegasNVUSA
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