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Kepper MM, Fowler LA, Kusters IS, Davis JW, Baqer M, Sagui-Henson S, Xiao Y, Tarfa A, Yi JC, Gibson B, Heron KE, Alberts NM, Burgermaster M, Njie-Carr VP, Klesges LM. Expanding a Behavioral View on Digital Health Access: Drivers and Strategies to Promote Equity. J Med Internet Res 2024; 26:e51355. [PMID: 39088246 PMCID: PMC11327633 DOI: 10.2196/51355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 05/02/2024] [Accepted: 05/27/2024] [Indexed: 08/02/2024] Open
Abstract
The potential and threat of digital tools to achieve health equity has been highlighted for over a decade, but the success of achieving equitable access to health technologies remains challenging. Our paper addresses renewed concerns regarding equity in digital health access that were deepened during the COVID-19 pandemic. Our viewpoint is that (1) digital health tools have the potential to improve health equity if equitable access is achieved, and (2) improving access and equity in digital health can be strengthened by considering behavioral science-based strategies embedded in all phases of tool development. Using behavioral, equity, and access frameworks allowed for a unique and comprehensive exploration of current drivers of digital health inequities. This paper aims to present a compilation of strategies that can potentially have an actionable impact on digital health equity. Multilevel factors drive unequal access, so strategies require action from tool developers, individual delivery agents, organizations, and systems to effect change. Strategies were shaped with a behavioral medicine focus as the field has a unique role in improving digital health access; arguably, all digital tools require the user (individual, provider, and health system) to change behavior by engaging with the technology to generate impact. This paper presents a model that emphasizes using multilevel strategies across design, delivery, dissemination, and sustainment stages to advance digital health access and foster health equity.
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Affiliation(s)
- Maura M Kepper
- Prevention Research Center, Washington University in St. Louis, St. Louis, MO, United States
| | - Lauren A Fowler
- Sexuality, Health, and Gender Center, Washington University in St. Louis School of Medicine, Saint Louis, MO, United States
| | - Isabelle S Kusters
- Department of Health, Human, and Biomedical Sciences, University of Houston-Clear Lake, Houston, TX, United States
- Center for Medical Ethics and Health Policy, Baylor College of Medicine, Houston, TX, United States
| | - Jean W Davis
- College of Nursing, University of Central Florida, Orlando, FL, United States
| | - Manal Baqer
- Neamah Health Consulting, Boston, MA, United States
| | - Sara Sagui-Henson
- Clinical Strategy and Research Team, Modern Health, San Francisco, CA, United States
| | - Yunyu Xiao
- Department of Population Health Science, Weill Cornell Medicine, Cornell University, New York, NY, United States
| | - Adati Tarfa
- School of Medicine, Yale University, New Haven, CT, United States
| | - Jean C Yi
- Fred Hutchinson Cancer Center, Seattle, WA, United States
| | - Bryan Gibson
- Department of Biomedical Informatics, University of Utah School of Medicine, Salt Lake City, UT, United States
| | - Kristin E Heron
- Psychology Department, Old Dominion University, Norfolk, VA, United States
- Virginia Consortium Program in Clinical Psychology, Norfolk, VA, United States
| | - Nicole M Alberts
- Department of Psychology, Concordia University, Montreal, QC, Canada
| | - Marissa Burgermaster
- Department of Nutritional Sciences, University of Texas at Austin, Austin, TX, United States
- Department of Population Health, Dell Medical School, University of Texas at Austin, Austin, TX, United States
| | - Veronica Ps Njie-Carr
- Department of Organizational Systems and Adult Health, University of Maryland, Baltimore, MD, United States
| | - Lisa M Klesges
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, MO, United States
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Pommerenke C, Poloczek S, Breuer F, Wolff J, Dahmen J. Automated and app-based activation of first responders for prehospital cardiac arrest: an analysis of 16.500 activations of the KATRETTER system in Berlin. Scand J Trauma Resusc Emerg Med 2023; 31:105. [PMID: 38124125 PMCID: PMC10731739 DOI: 10.1186/s13049-023-01152-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2023] [Accepted: 11/13/2023] [Indexed: 12/23/2023] Open
Abstract
BACKGROUND Bystander CPR is one of the main independent factors contributing to better survival after out-of-hospital cardiac arrest. Simultaneously, the rate of bystander CPR in Germany is below the European average. First responder applications (apps) contribute to reducing the time period without CPR (no-flow time) until professional help can arrive on-scene. METHODS The KATRETTER app was introduced in Berlin as one of the first apps in Europe which do not require any medical qualifications to register as a first responder. The activation of volunteer first responders for suspected cardiac arrest cases through the Berlin Emergency Medical Services integrated control center was evaluated based on data collected between 16 Oct 2020 and 16 Oct 2022. Our descriptive analysis includes the number of registered first responders, number of activations, the number and percentages of accepted activations, as well as all reports where first responders arrived at the scene. RESULTS As of 15 Oct 2022, a total of 10,102 first responders were registered in the state of Berlin. During this specified period, there were 16.505 activations of the system for suspected out-of-hospital cardiac arrest. In 38.4% of the accepted cases, first responders documented patient contact, and in 34.6% of cases with patient contact, CPR was performed. Only 2% of registered first responders did not have any medical qualifications. CONCLUSIONS Smartphone-based first responder applications should not be understood as a means of alerting professional help, but rather like a digitally amplified "call for help" in the vicinity of an emergency location. A large number of first responders can be recruited within 24 months, without large-scale public relations work necessary. No qualifications were required to become a first responder, contributing to a low-threshold registration process with the effect of a more widespread distribution of the app and cost reduction during implementation.
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Affiliation(s)
- C Pommerenke
- Charité University Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - S Poloczek
- Chief Medical Director, Emergency Medical Services, Fire Department, Berlin, Germany
| | - F Breuer
- Emergency Medical Services Director, Rhine-Berg-District, Office for Fire Protection and Emergency Medical Service, Bergisch Gladbach, Germany
| | - J Wolff
- Department of Anesthesia, Intensive Care and Emergency Medicine, Military Hospital Berlin, Berlin, Germany
| | - J Dahmen
- Department of Medicine, Health Faculty, University Witten/Herdecke, Witten, Germany.
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3
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Marijon E, Narayanan K, Smith K, Barra S, Basso C, Blom MT, Crotti L, D'Avila A, Deo R, Dumas F, Dzudie A, Farrugia A, Greeley K, Hindricks G, Hua W, Ingles J, Iwami T, Junttila J, Koster RW, Le Polain De Waroux JB, Olasveengen TM, Ong MEH, Papadakis M, Sasson C, Shin SD, Tse HF, Tseng Z, Van Der Werf C, Folke F, Albert CM, Winkel BG. The Lancet Commission to reduce the global burden of sudden cardiac death: a call for multidisciplinary action. Lancet 2023; 402:883-936. [PMID: 37647926 DOI: 10.1016/s0140-6736(23)00875-9] [Citation(s) in RCA: 26] [Impact Index Per Article: 26.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 04/13/2023] [Accepted: 04/25/2023] [Indexed: 09/01/2023]
Abstract
Despite major advancements in cardiovascular medicine, sudden cardiac death (SCD) continues to be an enormous medical and societal challenge, claiming millions of lives every year. Efforts to prevent SCD are hampered by imperfect risk prediction and inadequate solutions to specifically address arrhythmogenesis. Although resuscitation strategies have witnessed substantial evolution, there is a need to strengthen the organisation of community interventions and emergency medical systems across varied locations and health-care structures. With all the technological and medical advances of the 21st century, the fact that survival from sudden cardiac arrest (SCA) remains lower than 10% in most parts of the world is unacceptable. Recognising this urgent need, the Lancet Commission on SCD was constituted, bringing together 30 international experts in varied disciplines. Consistent progress in tackling SCD will require a completely revamped approach to SCD prevention, with wide-sweeping policy changes that will empower the development of both governmental and community-based programmes to maximise survival from SCA, and to comprehensively attend to survivors and decedents' families after the event. International collaborative efforts that maximally leverage and connect the expertise of various research organisations will need to be prioritised to properly address identified gaps. The Commission places substantial emphasis on the need to develop a multidisciplinary strategy that encompasses all aspects of SCD prevention and treatment. The Commission provides a critical assessment of the current scientific efforts in the field, and puts forth key recommendations to challenge, activate, and intensify efforts by both the scientific and global community with new directions, research, and innovation to reduce the burden of SCD worldwide.
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Affiliation(s)
- Eloi Marijon
- Division of Cardiology, European Georges Pompidou Hospital, AP-HP, Paris, France; Université Paris Cité, Inserm, PARCC, Paris, France; Paris-Sudden Death Expertise Center (Paris-SDEC), Paris, France.
| | - Kumar Narayanan
- Université Paris Cité, Inserm, PARCC, Paris, France; Paris-Sudden Death Expertise Center (Paris-SDEC), Paris, France; Medicover Hospitals, Hyderabad, India
| | - Karen Smith
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia; Silverchain Group, Melbourne, VIC, Australia
| | - Sérgio Barra
- Department of Cardiology, Hospital da Luz Arrábida, Vila Nova de Gaia, Portugal
| | - Cristina Basso
- Cardiovascular Pathology Unit-Azienda Ospedaliera and Department of Cardiac Thoracic and Vascular Sciences and Public Health, University of Padua, Padua, Italy
| | - Marieke T Blom
- Department of General Practice, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Lia Crotti
- Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy; Istituto Auxologico Italiano, IRCCS, Center for Cardiac Arrhythmias of Genetic Origin, Cardiomyopathy Unit and Laboratory of Cardiovascular Genetics, Department of Cardiology, Milan, Italy
| | - Andre D'Avila
- Department of Cardiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA; Department of Cardiology, Hospital SOS Cardio, Santa Catarina, Brazil
| | - Rajat Deo
- Department of Cardiology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Florence Dumas
- Université Paris Cité, Inserm, PARCC, Paris, France; Paris-Sudden Death Expertise Center (Paris-SDEC), Paris, France; Emergency Department, Cochin Hospital, Paris, France
| | - Anastase Dzudie
- Cardiology and Cardiac Arrhythmia Unit, Department of Internal Medicine, DoualaGeneral Hospital, Douala, Cameroon; Yaounde Faculty of Medicine and Biomedical Sciences, University of Yaounde 1, Yaounde, Cameroon
| | - Audrey Farrugia
- Hôpitaux Universitaires de Strasbourg, France, Strasbourg, France
| | - Kaitlyn Greeley
- Division of Cardiology, European Georges Pompidou Hospital, AP-HP, Paris, France; Université Paris Cité, Inserm, PARCC, Paris, France; Paris-Sudden Death Expertise Center (Paris-SDEC), Paris, France
| | | | - Wei Hua
- Cardiac Arrhythmia Center, FuWai Hospital, Beijing, China
| | - Jodie Ingles
- Centre for Population Genomics, Garvan Institute of Medical Research and UNSW Sydney, Sydney, NSW, Australia
| | - Taku Iwami
- Kyoto University Health Service, Kyoto, Japan
| | - Juhani Junttila
- MRC Oulu, University of Oulu and Oulu University Hospital, Oulu, Finland
| | - Rudolph W Koster
- Heart Center, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | | | - Theresa M Olasveengen
- Department of Anesthesia and Intensive Care Medicine, Oslo University Hospital and Institute of Clinical Medicine, Oslo, Norway
| | - Marcus E H Ong
- Singapore General Hospital, Duke-NUS Medical School, Singapore
| | - Michael Papadakis
- Cardiovascular Clinical Academic Group, St George's University of London, London, UK
| | | | - Sang Do Shin
- Department of Emergency Medicine at the Seoul National University College of Medicine, Seoul, South Korea
| | - Hung-Fat Tse
- University of Hong Kong, School of Clinical Medicine, Queen Mary Hospital, Hong Kong Special Administrative Region, China; Cardiac and Vascular Center, The University of Hong Kong-Shenzhen Hospital, Shenzhen, China
| | - Zian Tseng
- Division of Cardiology, UCSF Health, University of California, San Francisco Medical Center, San Francisco, California
| | - Christian Van Der Werf
- University of Amsterdam, Heart Center, Amsterdam, Netherlands; Department of Clinical and Experimental Cardiology, Amsterdam University Medical Centers, Amsterdam, Netherlands
| | - Fredrik Folke
- Department of Cardiology, Copenhagen University Hospital - Herlev and Gentofte, Herlev, Denmark; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Christine M Albert
- Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Bo Gregers Winkel
- Department of Cardiology, University Hospital Copenhagen, Rigshospitalet, Copenhagen, Denmark
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Saposnik G. Understanding social media: how its popularity could be used to advance medical education in stroke care? J Neurol 2023:10.1007/s00415-023-11743-w. [PMID: 37202604 DOI: 10.1007/s00415-023-11743-w] [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: 04/07/2023] [Revised: 04/23/2023] [Accepted: 04/24/2023] [Indexed: 05/20/2023]
Abstract
The wide availability of social media (SM) has revolutionized human interactions and education in different settings (e.g., household, workplace, academic, hospitals). Nearly 60% of the global population spend a daily average of over 6 h of screen time. By facilitating audio, video, and interactive material, SM has reshaped users' perceptions, choices, and communication. The science behind SM can be explained by the activation of the brain reward pathways which explains the success of SM platforms lead by user-generated content (i.e., TikTok). Our understanding of SM user's interests, mode of access, time spent with screens, and internet are critical to advance medical education by applying new learning technologies to advance medical education and stroke care. For example, the top 20 most visited websites and the most searched hashtags on TikTok in 2022 did not include any health-related topics, reflecting a challenging competition for attention of different segments of the population. We must overcome current gaps in medical education such as increased curricular activities, increasingly demanding tasks, differences in personal preferences between residents and faculty members, etc. New strategies using more engaging learning technologies and SM platforms (e.g., stroke simulations, interactive diagnostic and therapeutic decisions, tracking user's attention to assess knowledge transfer) are needed. This would allow a more effective delivery of educational content by stimulating the curiosity and participation of students, patients, and physicians offering more rewarding experiences across the continuum of stroke care.
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Affiliation(s)
- Gustavo Saposnik
- Decision Neuroscience Unit, Li Ka Shing Institute, University of Toronto, Toronto, Canada.
- Division of Neurology, Department of Medicine, St. Michael's Hospital, University of Toronto, 55 Queen St E, Toronto, ON, M5C 1R6, Canada.
- World Stroke Academy (WSA), World Stroke Organization (WSO), Geneva, Switzerland.
- NeuroEconSolutions.com, Toronto, Canada.
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Schroeder DC, Semeraro F, Greif R, Bray J, Morley P, Parr M, Kondo Nakagawa N, Iwami T, Finke SR, Malta Hansen C, Lockey A, Del Rios M, Bhanji F, Sasson C, Schexnayder SM, Scquizzato T, Wetsch WA, Böttiger BW. Temporarily Removed. Resuscitation 2023:109772. [PMID: 37190748 DOI: 10.1016/j.resuscitation.2023.109772] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
BACKGROUND Basic life support education for schoolchildren has become a key initiative to increase bystander cardiopulmonary resuscitation rates. Our objective was to review the existing literature on teaching schoolchildren basic life support to identify the best practices to provide basic life support training in schoolchildren. METHODS After topics and subgroups were defined, a comprehensive literature search was conducted. Systematic reviews and controlled and uncontrolled prospective and retrospective studies containing data on students <20 years of age were included. RESULTS Schoolchildren are highly motivated to learn basic life support. The CHECK-CALL-COMPRESS algorithm is recommended for all schoolchildren. Regular training in basic life support regardless of age consolidates long-term skills. Young children from 4 years of age are able to assess the first links in the chain of survival. By 10 to 12 years of age, effective chest compression depths and ventilation volumes can be achieved on training manikins. A combination of theoretical and practical training is recommended. Schoolteachers serve as effective basic life support instructors. Schoolchildren also serve as multipliers by passing on basic life support skills to others. The use of age-appropriate social media tools for teaching is a promising approach for schoolchildren of all ages. CONCLUSIONS Schoolchildren basic life support training has the potential to educate whole generations to respond to cardiac arrest and to increase survival after out-of-hospital cardiac arrest. Comprehensive legislation, curricula, and scientific assessment are crucial to further develop the education of schoolchildren in basic life support.
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Folke F, Shahriari P, Hansen CM, Gregers MCT. Public access defibrillation: challenges and new solutions. Curr Opin Crit Care 2023; 29:168-174. [PMID: 37093002 PMCID: PMC10155700 DOI: 10.1097/mcc.0000000000001051] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/25/2023]
Abstract
PURPOSE OF REVIEW The purpose of this article is to review the current status of public access defibrillation and the various utility modalities of early defibrillation. RECENT FINDINGS Defibrillation with on-site automated external defibrillators (AEDs) has been the conventional approach for public access defibrillation. This strategy is highly effective in cardiac arrests occurring in close proximity to on-site AEDs; however, only a few cardiac arrests will be covered by this strategy. During the last decades, additional strategies for public access defibrillation have developed, including volunteer responder programmes and drone assisted AED-delivery. These programs have increased chances of early defibrillation within a greater radius, which remains an important factor for survival after out-of-hospital cardiac arrest. SUMMARY Recent advances in the use of public access defibrillation show great potential for optimizing early defibrillation. With new technological solutions, AEDs can be transported to the cardiac arrest location reaching OHCAs in both public and private locations. Furthermore, new technological innovations could potentially identify and automatically alert the emergency medical services in nonwitnessed OHCA previously left untreated.
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Affiliation(s)
- Fredrik Folke
- Copenhagen University Hospital - Emergency Medical Services Capital Region
- Department of Clinical Medicine, University of Copenhagen
- Department of Cardiology, Copenhagen University Hospital - Herlev and Gentofte
| | - Persia Shahriari
- Copenhagen University Hospital - Emergency Medical Services Capital Region
- Department of Clinical Medicine, University of Copenhagen
| | - Carolina Malta Hansen
- Copenhagen University Hospital - Emergency Medical Services Capital Region
- Department of Cardiology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Mads Christian Tofte Gregers
- Copenhagen University Hospital - Emergency Medical Services Capital Region
- Department of Clinical Medicine, University of Copenhagen
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Public emotions and opinions following the sudden cardiac arrest of a young athlete: A sentiment analysis. Am J Emerg Med 2023; 67:179-181. [PMID: 36925351 DOI: 10.1016/j.ajem.2023.03.015] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 03/07/2023] [Accepted: 03/07/2023] [Indexed: 03/11/2023] Open
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Schwamm LH, Silva GS. Advances in Digital Health. Stroke 2023; 54:870-872. [PMID: 36848430 DOI: 10.1161/strokeaha.123.042098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/01/2023]
Affiliation(s)
- Lee H Schwamm
- Mass General Hospital, Harvard Medical School, Boston, MA (L.H.S.)
| | - Gisele Sampaio Silva
- Federal University of São Paulo, and Albert Einstein Hospital, SP, Brazil (G.S.S.)
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Mavragani A, Larribau R, Safin S, Pages R, Soichet H, Rizza C. The Integration of Live Video Tools to Help Bystanders During an Emergency Call: Protocol for a Mixed Methods Simulation Study. JMIR Res Protoc 2023; 12:e40699. [PMID: 36723999 PMCID: PMC9932876 DOI: 10.2196/40699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 10/28/2022] [Accepted: 11/24/2022] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Early action by bystanders is particularly important for the survival of individuals in need of emergency care, especially those experiencing a cardiac arrest or an airway obstruction. However, only a few bystanders are willing to perform cardiopulmonary resuscitation. The use of a live video during emergency calls appears to have a positive effect on the number of cardiopulmonary resuscitations performed by bystanders. OBJECTIVE The objective of this study is to propose and evaluate the relevance of a living lab methodology involving video calls in simulated life-threatening emergency situations. METHODS The first study aimed at analyzing the process of dealing with out-of-hospital cardiac arrest at a dispatch center and identifying the needs of the dispatchers. The second study is a pretest of a living lab. The third study focuses on a living lab in which 16 situations of cardiac arrest and airway obstruction are simulated. The simulation includes both a live video and transmission of a video demonstration of emergency procedures. The measures focus on 3 areas: the impact of video tools, development of collaboration within the community, and evaluation of the method. RESULTS The results of the first study show that dispatchers have an interest in visualizing the scene with live video and in broadcasting a live demonstration video when possible. The initial results also show that collaboration within the community is enhanced by the shared simulation and debriefing experiences, clarifying regulation procedures, and improving communication. Finally, an iterative development based on the lessons learned, expectations, and constraints of each previous study promotes the existence of a living lab that aims to determine the place of live video tools in the sequence of care performed by dispatchers. CONCLUSIONS Living labs offer the opportunity to grasp previously undetected insights and refine the use of the applications while potentially developing a sense of community among the stakeholders. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/40699.
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Affiliation(s)
| | - Robert Larribau
- Emergency Departement, Geneva University Hospitals, Geneva, Switzerland
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Bezzubtseva M, Demkina A, Lipilina M, Benimetskaya K, Pivenstein A, Gavrilyuk N, Isaeva A, Lobzhanidze F, Podgorodetskaya N, Klyashtornyj V, Taskina VY, Pogosova N. Video or text? Education through a social media website in hypertension. INTERNATIONAL JOURNAL OF CARDIOLOGY CARDIOVASCULAR RISK AND PREVENTION 2022; 14:200139. [PMID: 36060291 PMCID: PMC9434406 DOI: 10.1016/j.ijcrp.2022.200139] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Revised: 05/13/2022] [Accepted: 05/27/2022] [Indexed: 11/30/2022]
Abstract
Background Currently, several studies are available on the effective use of the Instagram social media platform to conduct training projects for CVD patients. The aim of this study was to determine the most effective methods (text or video) of informing people about the primary prevention of hypertension using a social media website. Materials and methods A total of 125 participants were randomly selected and assigned to one of the four training groups depending on the training mode, i.e. text posts (4000 characters) - Group 1, video clips (5 min) - Group 2, text followed by video - Group 3 and video followed by text - Group 4. Before and after training, respondents in all four groups completed the Heart Disease Knowledge Questionnaire (HDKQ). Results The total number of people who listened to and read the materials of the online school was 2108 people. Before training, the number of correct responses for 29 HDKQ statements was 18.4 ± 5.1, after training it increased to 21.9 ± 3.9 (CI, 21; 22.7) (p < 0.0001). The post-hoc analysis showed that after training the participants in Group 4 had more correct responses than the respondents in Group 3, 2, 1 i.e. Δ = 5.2, Δ = 1.5, Δ = 0.3, respectively. The respondents from Group 3 gave the lowest number of correct responses in other groups. Conclusions The most effective method of informing people about the primary prevention of hypertension using a social media website corresponded to the following sequence: a video clip followed by a text post.
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Affiliation(s)
| | - A.E. Demkina
- National Medical Research Centre of Cardiology of the Ministry of Health of the Russian Federation, Moscow, Russia
- Research and Practical Clinical Centre for Diagnostics and Telemedicine Technologies of the Moscow Healthcare Department, Moscow, Russia
| | | | - K.S. Benimetskaya
- Federal Research Centre Institute of Cytology and Genetics of the Siberian Branch of the Russian Academy of Sciences, Novosibirsk, Russia
| | | | - N.D. Gavrilyuk
- Almazov National Medical Research Centre of the Ministry of Health of Russia, St. Petersburg, Russia
| | - A.V. Isaeva
- Central City Hospital, No. 20, Yekaterinburg, Russia
| | | | | | - V.G. Klyashtornyj
- Research and Practical Clinical Centre for Diagnostics and Telemedicine Technologies of the Moscow Healthcare Department, Moscow, Russia
| | - V. Yu Taskina
- Research and Practical Clinical Centre for Diagnostics and Telemedicine Technologies of the Moscow Healthcare Department, Moscow, Russia
| | - N.V. Pogosova
- National Medical Research Centre of Cardiology of the Ministry of Health of the Russian Federation, Moscow, Russia
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11
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Affiliation(s)
- Gisele Sampaio Silva
- Universidade Federal de São Paulo, Department of Neurology and Neurosurgery, Brazil (G.S.S.).,Academic Research Organization, Hospital Israelita Albert Einstein, São Paulo, Brazil (G.S.S.)
| | - Lee H Schwamm
- Virtual Care, Mass General Brigham Digital, Boston, MA (L.H.S.).,Massachusetts General Hospital, Boston (L.H.S.).,Harvard Medical School, Boston, MA (L.H.S.)
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Brooks SC, Clegg GR, Bray J, Deakin CD, Perkins GD, Ringh M, Smith CM, Link MS, Merchant RM, Pezo-Morales J, Parr M, Morrison LJ, Wang TL, Koster RW, Ong MEH. Optimizing Outcomes After Out-of-Hospital Cardiac Arrest With Innovative Approaches to Public-Access Defibrillation: A Scientific Statement From the International Liaison Committee on Resuscitation. Circulation 2022; 145:e776-e801. [PMID: 35164535 DOI: 10.1161/cir.0000000000001013] [Citation(s) in RCA: 36] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Out-of-hospital cardiac arrest is a global public health issue experienced by ≈3.8 million people annually. Only 8% to 12% survive to hospital discharge. Early defibrillation of shockable rhythms is associated with improved survival, but ensuring timely access to defibrillators has been a significant challenge. To date, the development of public-access defibrillation programs, involving the deployment of automated external defibrillators into the public space, has been the main strategy to address this challenge. Public-access defibrillator programs have been associated with improved outcomes for out-of-hospital cardiac arrest; however, the devices are used in <3% of episodes of out-of-hospital cardiac arrest. This scientific statement was commissioned by the International Liaison Committee on Resuscitation with 3 objectives: (1) identify known barriers to public-access defibrillator use and early defibrillation, (2) discuss established and novel strategies to address those barriers, and (3) identify high-priority knowledge gaps for future research to address. The writing group undertook systematic searches of the literature to inform this statement. Innovative strategies were identified that relate to enhanced public outreach, behavior change approaches, optimization of static public-access defibrillator deployment and housing, evolved automated external defibrillator technology and functionality, improved integration of public-access defibrillation with existing emergency dispatch protocols, and exploration of novel automated external defibrillator delivery vectors. We provide evidence- and consensus-based policy suggestions to enhance public-access defibrillation and guidance for future research in this area.
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Brooks SC, Clegg GR, Bray J, Deakin CD, Perkins GD, Ringh M, Smith CM, Link MS, Merchant RM, Pezo-Morales J, Parr M, Morrison LJ, Wang TL, Koster RW, Ong MEH. Optimizing outcomes after out-of-hospital cardiac arrest with innovative approaches to public-access defibrillation: A scientific statement from the International Liaison Committee on Resuscitation. Resuscitation 2022; 172:204-228. [PMID: 35181376 DOI: 10.1016/j.resuscitation.2021.11.032] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Out-of-hospital cardiac arrest is a global public health issue experienced by ≈3.8 million people annually. Only 8% to 12% survive to hospital discharge. Early defibrillation of shockable rhythms is associated with improved survival, but ensuring timely access to defibrillators has been a significant challenge. To date, the development of public-access defibrillation programs, involving the deployment of automated external defibrillators into the public space, has been the main strategy to address this challenge. Public-access defibrillator programs have been associated with improved outcomes for out-of-hospital cardiac arrest; however, the devices are used in <3% of episodes of out-of-hospital cardiac arrest. This scientific statement was commissioned by the International Liaison Committee on Resuscitation with 3 objectives: (1) identify known barriers to public-access defibrillator use and early defibrillation, (2) discuss established and novel strategies to address those barriers, and (3) identify high-priority knowledge gaps for future research to address. The writing group undertook systematic searches of the literature to inform this statement. Innovative strategies were identified that relate to enhanced public outreach, behavior change approaches, optimization of static public-access defibrillator deployment and housing, evolved automated external defibrillator technology and functionality, improved integration of public-access defibrillation with existing emergency dispatch protocols, and exploration of novel automated external defibrillator delivery vectors. We provide evidence- and consensus-based policy suggestions to enhance public-access defibrillation and guidance for future research in this area.
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Allan KS, O'Neil E, Currie MM, Lin S, Sapp JL, Dorian P. Responding to Cardiac Arrest in the Community in the Digital Age. Can J Cardiol 2021; 38:491-501. [PMID: 34954009 DOI: 10.1016/j.cjca.2021.12.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 12/14/2021] [Accepted: 12/14/2021] [Indexed: 01/25/2023] Open
Abstract
Sudden cardiac arrest (SCA) is a common event, affecting almost 400,000 individuals annually in North America. Initiation of cardiopulmonary resuscitation (CPR) and early defibrillation using an automated external defibrillator (AED) are critical for survival, yet many bystanders are reluctant to intervene. Digital technologies, including mobile devices, social media and crowdsourcing may help play a role to improve survival from SCA. In this article we review the current digital tools and strategies available to increase rates of bystander recognition of SCA, prompt immediate activation of Emergency Medical Services (EMS), initiate high quality CPR and to locate, retrieve and operate AEDs. Smartphones can help to both educate and connect bystanders with EMS dispatchers, through text messaging or video-calling, to encourage the initiation of CPR and retrieval of the closest AED. Wearable devices and household smartspeakers could play a future role in continuous vital signs monitoring in individuals at-risk of lethal arrhythmias and send an alert to either chosen contacts or EMS. Machine learning algorithms and mathematical modeling may aid EMS dispatchers with better recognition of SCA as well as policymakers with where to best place AEDs for optimal accessibility. There are challenges with the use of digital tech, including the need for government regulation and issues with data ownership, accessibility and interoperability. Future research will include smart cities, e-linkages, new technologies and using social media for mass education. Together or in combination, these emerging digital technologies may represent the next leap forward in SCA survival.
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Affiliation(s)
- Katherine S Allan
- Division of Cardiology, Unity Health Toronto - St. Michael's Hospital, Toronto, Ontario, Canada.
| | - Emma O'Neil
- Department of Emergency Medicine, Unity Health Toronto - St. Michael's Hospital, Toronto, Ontario, Canada
| | - Margaret M Currie
- Faculty of Science, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Steve Lin
- Department of Emergency Medicine, Unity Health Toronto - St. Michael's Hospital, Toronto, Ontario, Canada; Keenan Research Centre, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario Canada; Department of Medicine, University of Toronto, Toronto, Ontario, Canada; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
| | - John L Sapp
- Department of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada; Queen Elizabeth II Health Sciences Centre, Halifax, Nova Scotia, Canada
| | - Paul Dorian
- Division of Cardiology, Unity Health Toronto - St. Michael's Hospital, Toronto, Ontario, Canada; Keenan Research Centre, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario Canada; Department of Medicine, University of Toronto, Toronto, Ontario, Canada
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15
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Jellestad ASL, Folke F, Molin R, Lyngby RM, Hansen CM, Andelius L. Collaboration between emergency physicians and citizen responders in out-of-hospital cardiac arrest resuscitation. Scand J Trauma Resusc Emerg Med 2021; 29:110. [PMID: 34344415 PMCID: PMC8330065 DOI: 10.1186/s13049-021-00927-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Accepted: 07/19/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Citizen responder programmes dispatch volunteer citizens to initiate resuscitation in nearby out-of-hospital cardiac arrests (OHCA) before the Emergency Medical Services (EMS) arrival. Little is known about the interaction between citizen responders and EMS personnel during the resuscitation attempt. In the Capital Region of Denmark, emergency physicians are dispatched to all suspected OHCAs. The aim of this study was to evaluate how emergency physicians perceived the collaboration with citizen responders during resuscitation attempts. METHOD This cross-sectional study was conducted through an online questionnaire. It included all 65 emergency physicians at Copenhagen EMS between June 9 and December 13, 2019 (catchment area 1.8 million). The questionnaire examined how emergency physicians perceived the interaction with citizen responders at the scene of OHCA (use of citizen responders before and after EMS arrival, citizen responders' skills in cardiopulmonary resuscitation (CPR), and challenges in this setting). RESULTS The response rate was 87.7% (57/65). Nearly all emergency physicians (93.0%) had interacted with a citizen responder at least once. Of those 92.5%(n = 49) considered it relevant to activate citizen responders to OHCA resuscitation, and 67.9%(n = 36) reported the collaboration as helpful. When citizen responders arrived before EMS, 75.5%(n = 40) of the physicians continued to use citizen responders to assist with CPR or to carry equipment. Most (84.9%, n = 45) stated that citizen responders had the necessary skills to perform CPR. Challenges in the collaboration were described by 20.7%(n = 11) of the emergency physicians and included citizen responders being mistaken for relatives, time-consuming communication, or crowding problems during resuscitation. CONCLUSION Emergency physicians perceived the collaboration with citizen responders as valuable, not only for delivery of CPR, but were also considered an extra helpful resource providing non-CPR related tasks such as directing the EMS to the arrest location, carrying equipment and taking care of relatives.
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Affiliation(s)
- Anne-Sofie Linde Jellestad
- Copenhagen Emergency Medical Services, University of Copenhagen, Telegrafvej 5, opgang 2, 3. sal, 2750, Ballerup, Denmark. .,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.
| | - Fredrik Folke
- Copenhagen Emergency Medical Services, University of Copenhagen, Telegrafvej 5, opgang 2, 3. sal, 2750, Ballerup, Denmark.,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.,Department of Cardiology, Herlev-Gentofte University Hospital, Copenhagen, Denmark
| | - Rune Molin
- Copenhagen Emergency Medical Services, University of Copenhagen, Telegrafvej 5, opgang 2, 3. sal, 2750, Ballerup, Denmark
| | - Rasmus Meyer Lyngby
- Copenhagen Emergency Medical Services, University of Copenhagen, Telegrafvej 5, opgang 2, 3. sal, 2750, Ballerup, Denmark.,Kingston University and St. Georges, University of London, London, UK
| | - Carolina Malta Hansen
- Copenhagen Emergency Medical Services, University of Copenhagen, Telegrafvej 5, opgang 2, 3. sal, 2750, Ballerup, Denmark.,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.,Department of Cardiology, Herlev-Gentofte University Hospital, Copenhagen, Denmark
| | - Linn Andelius
- Copenhagen Emergency Medical Services, University of Copenhagen, Telegrafvej 5, opgang 2, 3. sal, 2750, Ballerup, Denmark.,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
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16
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Lin L, Ni S, Cheng J, Zhang Z, Zeng R, Jin X, Zhao Y. Effect of synchronous online vs. face-to-face cardiopulmonary resuscitation training on chest compression quality: A pilot randomized manikin study. Am J Emerg Med 2021; 50:80-84. [PMID: 34314941 DOI: 10.1016/j.ajem.2021.07.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 06/26/2021] [Accepted: 07/01/2021] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVES The aim of the study was to compare the effect of synchronous online and face-to-face cardiopulmonary resuscitation (CPR) training on chest compressions quality in a manikin model. METHODS A total of 118 fourth-year medical students participated in this study. The participants were divided into two groups: the online synchronous teaching group and the face-to-face group. Then, the participants were further randomly distributed to 1 of 2 feedback groups: online synchronous teaching and training with feedback devices (TF, n = 30) or without feedback devices (TN, n = 29) and face-to-face teaching and training with feedback devices (FF, n = 30) or without feedback devices (FN, n = 29). In the FN group and FF group, instructors delivered a 45-min CPR training program and gave feedback and guidance during training on site. In the TN group and TF group, the participants were trained with an online lecture via Tencent Meeting live broadcasting. Finally, participants performed a 2-min continuous chest compression (CC) during a simulated cardiopulmonary arrest scene without the audiovisual feedback (AVF) device. The outcome measures included CC depth, CC rate, proportions of appropriate depth (50-60 mm) and CC rate (100-120/min), percentage of correct hand location position, and percentage of complete chest recoil. RESULTS There was little difference in the CC quality between the synchronous online training groups and the face-to-face training groups. There was no statistically significant difference in CC quality between the TN group and FN group. There were also no statistically significant differences between the TF and FF groups in terms of correct hand position, CC depth, appropriate CC depth, complete chest recoil or CC rate. However, the FF group had a higher appropriate CC rate than the TF group (p = 0.045). In the face-to-face training groups, the AVF device group had a significantly greater CC depth, appropriate CC depth, CC rate, and appropriate CC rate. However, there was a lack of statistically significant differences in terms of correct hand position (p = 0.191) and appropriate CC depth (p = 0.123). In the synchronous online training groups, the AVF device had little effect on the CC rate (p = 0.851) and increased the appropriate CC rate, but the difference was not statistically significant (p = 0.178). CONCLUSIONS Synchronous online training with an AVF device would be a potential alternative approach to face-to-face chest compression training. Synchronous online training with AVF devices seems to be a suitable replacement for face-to-face training to offer adequate bystander CPR chest compression training.
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Affiliation(s)
- Lian Lin
- Emergency Center, Zhongnan Hospital of Wuhan University, 169 Donghu Road, Wuhan, Hubei 430071, China
| | - Shaozhou Ni
- Emergency Center, Zhongnan Hospital of Wuhan University, 169 Donghu Road, Wuhan, Hubei 430071, China; Hubei Clinical Research Center for Emergency and Resuscitation, Zhongnan Hospital of Wuhan University, 169 Donghu Road, Wuhan, Hubei 430071, China
| | - Jin Cheng
- Emergency Center, Zhongnan Hospital of Wuhan University, 169 Donghu Road, Wuhan, Hubei 430071, China
| | - Zhongxiang Zhang
- Emergency Center, Zhongnan Hospital of Wuhan University, 169 Donghu Road, Wuhan, Hubei 430071, China
| | - Rong Zeng
- Emergency Center, Zhongnan Hospital of Wuhan University, 169 Donghu Road, Wuhan, Hubei 430071, China
| | - Xiaoqing Jin
- Emergency Center, Zhongnan Hospital of Wuhan University, 169 Donghu Road, Wuhan, Hubei 430071, China; Hubei Clinical Research Center for Emergency and Resuscitation, Zhongnan Hospital of Wuhan University, 169 Donghu Road, Wuhan, Hubei 430071, China.
| | - Yan Zhao
- Emergency Center, Zhongnan Hospital of Wuhan University, 169 Donghu Road, Wuhan, Hubei 430071, China; Hubei Clinical Research Center for Emergency and Resuscitation, Zhongnan Hospital of Wuhan University, 169 Donghu Road, Wuhan, Hubei 430071, China.
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17
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Metelmann C, Metelmann B, Schuffert L, Hahnenkamp K, Vollmer M, Brinkrolf P. Smartphone apps to support laypersons in bystander CPR are of ambivalent benefit: a controlled trial using medical simulation. Scand J Trauma Resusc Emerg Med 2021; 29:76. [PMID: 34082804 PMCID: PMC8173850 DOI: 10.1186/s13049-021-00893-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2021] [Accepted: 05/19/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Bystander-initiated resuscitation is essential for surviving out-of-hospital cardiac arrest. Smartphone apps can provide real-time guidance for medical laypersons in these situations. Are these apps a beneficial addition to traditional resuscitation training? METHODS In this controlled trial, we assessed the impact of app use on the quality of resuscitation (hands-off time, assessment of the patient's condition, quality of chest compression, body and arm positioning). Pupils who have previously undergone a standardised resuscitation training, encountered a simulated cardiac arrest either (i) without an app (control group); (ii) with facultative app usage; or (iii) with mandatory app usage. Measurements were compared using generalised linear regression. RESULTS 200 pupils attended this study with 74 pupils in control group, 65 in facultative group and 61 in mandatory group. Participants who had to use the app significantly delayed the check for breathing, call for help, and first compression, leading to longer total hands-off time. Hands-off time during chest compression did not differ significantly. The percentage of correct compression rate and correct compression depth was significantly higher when app use was mandatory. Assessment of the patient's condition, and body and arm positioning did not differ. CONCLUSIONS Smartphone apps offering real-time guidance in resuscitation can improve the quality of chest compression but may also delay the start of resuscitation. Provided that the app gives easy-to-implement, guideline-compliant instructions and that the user is familiar with its operation, we recommend smartphone-guidance as an additional tool to hands-on CPR-training to increase the prevalence and quality of bystander-initiated CPR.
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Affiliation(s)
- Camilla Metelmann
- Department of Anaesthesiology, University Medicine Greifswald, Greifswald, Germany
| | - Bibiana Metelmann
- Department of Anaesthesiology, University Medicine Greifswald, Greifswald, Germany
| | - Louisa Schuffert
- Department of Anaesthesiology, University Medicine Greifswald, Greifswald, Germany
| | - Klaus Hahnenkamp
- Department of Anaesthesiology, University Medicine Greifswald, Greifswald, Germany
| | - Marcus Vollmer
- Institute of Bioinformatics, University Medicine Greifswald, Greifswald, Germany
| | - Peter Brinkrolf
- Department of Anaesthesiology, University Medicine Greifswald, Greifswald, Germany
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18
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Morgenstern J, Heitz C, Bond C, Milne WK. Hot Off the Press: Mobile Smartphone Technology Is Associated With Out-of-hospital Cardiac Arrest Survival Improvement. Acad Emerg Med 2021; 28:589-592. [PMID: 33187028 DOI: 10.1111/acem.14172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Accepted: 11/09/2020] [Indexed: 11/28/2022]
Affiliation(s)
| | - Corey Heitz
- the Virginia Tech Carilion School of Medicine Roanoke VAUSA
| | - Chris Bond
- the University of Calgary Calgary Alberta Canada
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19
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Bylow H, Karlsson T, Lepp M, Claesson A, Lindqvist J, Svensson L, Herlitz J. Learning Outcome After Different Combinations of Seven Learning Activities in Basic Life Support on Laypersons in Workplaces: a Cluster Randomised, Controlled Trial. MEDICAL SCIENCE EDUCATOR 2021; 31:161-173. [PMID: 34457876 PMCID: PMC8368380 DOI: 10.1007/s40670-020-01160-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 11/06/2020] [Indexed: 06/13/2023]
Abstract
BACKGROUND The goal for laypersons after training in basic life support (BLS) is to act effectively in an out-of-hospital cardiac arrest situation. However, it is still unclear whether BLS training targeting laypersons at workplaces is optimal or whether other effective learning activities are possible. AIM The primary aim was to evaluate whether there were other modes of BLS training that improved learning outcome as compared with a control group, i.e. standard BLS training, six months after training, and secondarily directly after training. METHODS In this multi-arm trial, lay participants (n = 2623) from workplaces were cluster randomised into 16 different BLS interventions, of which one, instructor-led and film-based BLS training, was classified as control and standard, with which the other 15 were compared. The learning outcome was the total score for practical skills in BLS calculated using the modified Cardiff Test. RESULTS Four different training modes showed a significantly higher total score compared with standard (mean difference 2.3-2.9). The highest score was for the BLS intervention including a preparatory web-based education, instructor-led training, film-based instructions, reflective questions and a chest compression feedback device (95% CI for difference 0.9-5.0), 6 months after training. CONCLUSION BLS training adding several different combinations of a preparatory web-based education, reflective questions and chest compression feedback to instructor-led training and film-based instructions obtained higher modified Cardiff Test total scores 6 months after training compared with standard BLS training alone. The differences were small in magnitude and the clinical relevance of our findings needs to be further explored. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT03618888. Registered August 07, 2018-Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT03618888. SUPPLEMENTARY INFORMATION The online version contains supplementary material available at 10.1007/s40670-020-01160-3.
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Affiliation(s)
- Helene Bylow
- Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Thomas Karlsson
- Health Metrics Unit, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Margret Lepp
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Østfold University College, Halden, Norway
- School of Nursing and Midwifery, Griffith University, Brisbane, Australia
| | - Andreas Claesson
- Department of Medicine, Centre for Resuscitation Science, Karolinska Institute, Stockholm, Sweden
| | | | - Leif Svensson
- Department of Medicine, Centre for Resuscitation Science, Karolinska Institute, Stockholm, Sweden
| | - Johan Herlitz
- Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Centre of Registers Västra Götaland, Gothenburg, Sweden
- Prehospen-Centre of Prehospital Research, Faculty of Caring Science, Work Life and Social Welfare, University of Borås, Borås, Sweden
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20
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Smartphone Activation of Citizen Responders to Facilitate Defibrillation in Out-of-Hospital Cardiac Arrest. J Am Coll Cardiol 2021; 76:43-53. [PMID: 32616162 DOI: 10.1016/j.jacc.2020.04.073] [Citation(s) in RCA: 107] [Impact Index Per Article: 35.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Revised: 04/13/2020] [Accepted: 04/27/2020] [Indexed: 12/18/2022]
Abstract
BACKGROUND Dispatching citizen responders through a smartphone application (app) holds the potential to increase bystander cardiopulmonary resuscitation (CPR) and defibrillation in out-of-hospital cardiac arrest (OHCA). OBJECTIVES This study investigated arrival at the OHCA location of app-dispatched citizen responders before the Emergency Medical Services (EMS) and the association with bystander CPR and bystander defibrillation. METHODS Suspected OHCAs with alerted citizen responders from September 1, 2017, to August 31, 2018, were included. Citizen responders located 1.8 km (1.1 miles) from the OHCA were dispatched to start CPR or retrieve an automated external defibrillator. OHCAs where at least 1 citizen responder arrived before EMS were compared with OHCAs where EMS arrived first. In both groups, random bystanders could be present before the arrival of citizen responders and the EMS. Primary outcomes were bystander CPR and bystander defibrillation, which included CPR and defibrillation by citizen responders and random bystanders. RESULTS Citizen responders were alerted in 819 suspected OHCAs, of which 438 (53.5%) were confirmed cardiac arrests eligible for inclusion. At least 1 citizen responder arrived before EMS in 42.0% (n = 184) of all included OHCAs. When citizen responders arrived before EMS, the odds for bystander CPR increased (odds ratio: 1.76; 95% confidence interval: 1.07 to 2.91; p = 0.027) and the odds for bystander defibrillation more than tripled (odds ratio: 3.73; 95% confidence interval: 2.04 to 6.84; p < 0.001) compared with OHCAs in which citizen responders arrived after EMS. CONCLUSIONS Arrival of app-dispatched citizen responders before EMS was associated with increased odds for bystander CPR and a more than 3-fold increase in odds for bystander defibrillation. (The HeartRunner Trial; NCT03835403).
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21
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Nas J, Thannhauser J, Vart P, van Geuns RJ, Muijsers HEC, Mol JQ, Aarts GWA, Konijnenberg LSF, Gommans DHF, Ahoud-Schoenmakers SGAM, Vos JL, van Royen N, Bonnes JL, Brouwer MA. Effect of Face-to-Face vs Virtual Reality Training on Cardiopulmonary Resuscitation Quality: A Randomized Clinical Trial. JAMA Cardiol 2021; 5:328-335. [PMID: 31734702 DOI: 10.1001/jamacardio.2019.4992] [Citation(s) in RCA: 51] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Importance Bystander cardiopulmonary resuscitation (CPR) is crucial for survival after cardiac arrest but not performed in most cases. New, low-cost, and easily accessible training methods, such as virtual reality (VR), may reach broader target populations, but data on achieved CPR skills are lacking. Objective To compare CPR quality between VR and face-to-face CPR training. Design, Setting, and Participants Randomized noninferiority trial with a prospective randomized open blinded end point design. Participants were adult attendees from the science section of the Lowlands Music Festival (August 16 to 18, 2019) in the Netherlands. Analysis began September 2019. Interventions Two standardized 20-minute protocols on CPR and automated external defibrillator use: instructor-led face-to-face training or VR training using a smartphone app endorsed by the Resuscitation Council (United Kingdom). Main Outcomes and Measures During a standardized CPR scenario following the training, we assessed the primary outcome CPR quality, measured as chest compression depth and rate using CPR manikins. Overall CPR performance was assessed by examiners, blinded for study groups, using a European Resuscitation Council-endorsed checklist (maximum score, 13). Additional secondary outcomes were chest compression fraction, proportions of participants with mean depth (50 mm-60 mm) or rate (100 min-1-120 min-1) within guideline ranges, and proportions compressions with full release. Results A total of 381 participants were randomized: 216 women (57%); median (interquartile range [IQR]) age, 26 (22-31) years. The VR app (n = 190 [49.9%]) was inferior to face-to-face training (n = 191 [50.1%]) for chest compression depth (mean [SD], VR: 49 [10] mm vs face to face: 57 [5] mm; mean [95% CI] difference, -8 [-9 to -6] mm), and noninferior for chest compression rate (mean [SD]: VR: 114 [12] min-1 vs face to face: 109 [12] min-1; mean [95% CI] difference, 6 [3 to 8] min-1). The VR group had lower overall CPR performance scores (median [IQR], 10 [8-12] vs 12 [12-13]; P < .001). Chest compression fraction (median [IQR], 61% [52%-66%] vs 67% [62%-71%]; P < .001) and proportions of participants fulfilling depth (51% [n = 89] vs 75% [n = 133], P < .001) and rate (50% [n = 87] vs 63% [n = 111], P = .01) requirements were also lower in the VR group. The proportion of compressions with full release was higher in the VR group (median [IQR], 98% [59%-100%] vs 88% [55%-99%]; P = .002). Conclusions and Relevance In this randomized noninferiority trial, VR training resulted in comparable chest compression rate but inferior compression depth compared with face-to-face training. Given the potential of VR training to reach a larger target population, further development is needed to achieve the compression depth and overall CPR skills acquired by face-to-face training. Trial Registration ClinicalTrials.gov identifier: NCT04013633.
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Affiliation(s)
- Joris Nas
- Department of Cardiology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Jos Thannhauser
- Department of Cardiology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Priya Vart
- Department of Cardiology, Radboud University Medical Center, Nijmegen, the Netherlands.,Department of Health Evidence, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Robert-Jan van Geuns
- Department of Cardiology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Hella E C Muijsers
- Department of Cardiology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Jan-Quinten Mol
- Department of Cardiology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Goaris W A Aarts
- Department of Cardiology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Lara S F Konijnenberg
- Department of Cardiology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - D H Frank Gommans
- Department of Cardiology, Radboud University Medical Center, Nijmegen, the Netherlands
| | | | - Jacqueline L Vos
- Department of Cardiology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Niels van Royen
- Department of Cardiology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Judith L Bonnes
- Department of Cardiology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Marc A Brouwer
- Department of Cardiology, Radboud University Medical Center, Nijmegen, the Netherlands
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22
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Choi S, Han S, Chae MK, Lee YH. Effects of vibration-guided cardiopulmonary resuscitation with a smartwatch versus metronome guidance cardiopulmonary resuscitation during adult cardiac arrest: a randomized controlled simulation study. Australas Emerg Care 2021; 24:302-307. [PMID: 33419698 DOI: 10.1016/j.auec.2020.12.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Revised: 11/26/2020] [Accepted: 12/17/2020] [Indexed: 10/22/2022]
Abstract
BACKGROUND Smartwatches could be used as a cardiopulmonary resuscitation (CPR) guidance system through its vibration function. This study was conducted to determine whether vibration guidance by a smartwatch application influences CPR performance compared to metronome guided CPR in a simulated noisy setting. METHODS This study was randomised controlled trial. A total of 130 university students were enrolled. The experiment was conducted using a cardiac arrest model with hands-only CPR. Participants were randomly divided into two groups 1:1 ratio and performed 2-min metronome guidance or vibration guidance compression at the rate of 110/min. Basic life support quality data were compared in simulated noisy environments. RESULTS There were significant differences between the audio and vibration guidance groups in the mean compression rate (MCR). However, there were no significant differences in correct or mean compression depth, correct hand position, and correctly released compression. The vibration guidance group resulted in 109 MCR (Interquartile range [IQR] 108-110), whereas the metronome guidance group resulted in 115 MCR (IQR 112-117) (p < 0.001). CONCLUSION In a simulated noisy environment, vibration guided CPR showed to be particularly advantageous in maintaining a desired MCR during hands-only CPR compared to metronome guided CPR.
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Affiliation(s)
- Sungwoo Choi
- Department of Emergency Medicine, Soonchunhyang University Bucheon Hospital, Bucheon, Republic of Korea
| | - Sangsoo Han
- Department of Emergency Medicine, Soonchunhyang University Bucheon Hospital, Bucheon, Republic of Korea
| | - Minjung Kathy Chae
- Department of Emergency Medicine, Ajou University Medical Center, Suwon, Republic of Korea
| | - Young Hwan Lee
- Department of Emergency Medicine, Soonchunhyang University Bucheon Hospital, Bucheon, Republic of Korea.
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Tseng D, d'Hemecourt P, Baggish AL, Troyanos C, Liu JH, Breaud AH, Dyer KS. Qualitative Assessment of a Medical Protocols Mobile Application at the Boston Marathon 2016. Clin J Sport Med 2021; 31:e8-e14. [PMID: 30589746 DOI: 10.1097/jsm.0000000000000693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To examine the creation of a medical protocols mobile application for the Boston Marathon and its use by medical volunteers for the 2016 Boston Marathon. DESIGN Anonymous questionnaire. SETTING 2016 Boston Marathon. PARTICIPANTS Two hundred ninety-four marathon medical volunteers. MAIN OUTCOME MEASURES Responses regarding ease of use, acceptability, and usefulness of the International Institute of Race Medicine mobile application. RESULTS In total, 88% of medical volunteers who participated in the study felt that the medical protocols mobile application was easy to use. Approximately 72% would use the app again, and 79% would recommend the app to others. However, only 15% of volunteers consistently used the app during the event, and 37% felt like it contributed to clinical decision-making. CONCLUSIONS A medical protocols app was found to be useful and well accepted among medical volunteers who reported using the app, but only a minority of respondents used the app on marathon day or felt like it contributed to clinical care. Although new, mobile apps in race medicine should continue to be an area of development as providers increasingly integrate their use into clinical practice.
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Affiliation(s)
- David Tseng
- Emergency Department, Boston Medical Center, Boston, Massachusetts
| | - Pierre d'Hemecourt
- Harvard Medical School, Boston, Massachusetts
- Sports Medicine, Boston Children's Hospital, Boston, Massachusetts
| | - Aaron L Baggish
- Harvard Medical School, Boston, Massachusetts
- Cardiology, Massachusetts General Hospital, Boston, Massachusetts
| | | | - James H Liu
- Emergency Department, Boston Medical Center, Boston, Massachusetts
| | - Alan H Breaud
- Emergency Department, Boston Medical Center, Boston, Massachusetts
| | - K Sophia Dyer
- Emergency Department, Boston Medical Center, Boston, Massachusetts
- Boston University School of Medicine, Boston, Massachusetts; and
- City of Boston Emergency Medical Services, Boston, Massachusetts
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Gutiérrez-Puertas L, García-Viola A, Márquez-Hernández VV, Garrido-Molina JM, Granados-Gámez G, Aguilera-Manrique G. Guess it (SVUAL): An app designed to help nursing students acquire and retain knowledge about basic and advanced life support techniques. Nurse Educ Pract 2020; 50:102961. [PMID: 33421681 DOI: 10.1016/j.nepr.2020.102961] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Revised: 12/14/2020] [Accepted: 12/22/2020] [Indexed: 11/24/2022]
Abstract
To design an app that helps nursing students to acquire and retain knowledge of Basic and Advanced Life Support techniques, as well as analyze the students' gamification experience. The study had two phases: 1) App design and development and 2) experimental study. A total of 184 students participated, with 92 in the experimental group and 92 in the control group. The instruments used were the Guess it (SVUAL) app, a test on knowledge and the Gameful Experience Scale. The app was deemed to have a suitable level of content and user-friendliness of 97%. The experimental group obtained a higher average score on the knowledge test than the control group (U = 2835.500; Z = -3.968; p < 0.05). On the re-test, the experimental group also obtained a higher average score than the control group. As for the experience within the game, all the dimensions scored higher than average, except the absence of negative effects dimension, which indicates that the app had very few negative consequences on the participants. The developed app has proven to have a good level of content and to be user-friendly, improving knowledge levels and retention of information in nursing students.
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Affiliation(s)
- Lorena Gutiérrez-Puertas
- Department of Nursing, Physiotherapy and Medicine, Faculty of Health Sciences, University of Almeria, Spain, Sacramento S/N, en La Cañada de San Urbano (CP: 04120), Spain.
| | - Alba García-Viola
- Department of Nursing, Physiotherapy and Medicine, Faculty of Health Sciences, University of Almeria, Spain, Sacramento S/N, en La Cañada de San Urbano (CP: 04120), Spain.
| | - Verónica V Márquez-Hernández
- Department of Nursing, Physiotherapy and Medicine, Faculty of Health Sciences, Research Group of Health Sciences CTS-451, University of Almeria, Spain, Sacramento S/N, en La Cañada de San Urbano (CP: 04120), Spain.
| | - José Miguel Garrido-Molina
- Empresa Pública de Emergencias Sanitarias 061, Edificio Antiguo Hospital Virgen Del Mar, Ctra. de Ronda, 226, 04009, Almería, Spain.
| | - Genoveva Granados-Gámez
- Department of Nursing, Physiotherapy and Medicine, Faculty of Health Sciences, Research Group of Health Sciences CTS-451, University of Almeria, Spain, Sacramento S/N, en La Cañada de San Urbano (CP: 04120), Spain.
| | - Gabriel Aguilera-Manrique
- Department of Nursing, Physiotherapy and Medicine, Faculty of Health Sciences, Research Group of Health Sciences CTS-451, University of Almeria, Spain, Sacramento S/N, en La Cañada de San Urbano (CP: 04120), Spain.
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Cheng A, Magid DJ, Auerbach M, Bhanji F, Bigham BL, Blewer AL, Dainty KN, Diederich E, Lin Y, Leary M, Mahgoub M, Mancini ME, Navarro K, Donoghue A. Part 6: Resuscitation Education Science: 2020 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation 2020; 142:S551-S579. [PMID: 33081527 DOI: 10.1161/cir.0000000000000903] [Citation(s) in RCA: 83] [Impact Index Per Article: 20.8] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Buttussi F, Chittaro L, Valent F. A virtual reality methodology for cardiopulmonary resuscitation training with and without a physical mannequin. J Biomed Inform 2020; 111:103590. [PMID: 33039589 DOI: 10.1016/j.jbi.2020.103590] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Revised: 10/01/2020] [Accepted: 10/04/2020] [Indexed: 11/27/2022]
Abstract
BACKGROUND Cardiopulmonary resuscitation (CPR) is an emergency procedure that can increase survival after a cardiac arrest. Performing CPR effectively requires both procedural knowledge and manual skills. Traditional CPR training methodology includes lessons led by instructors and supervised practice on mannequins, thus requiring considerable resources. OBJECTIVE This paper proposes a new methodology for low-cost CPR training based on virtual reality (VR) with and without the addition of a physical mannequin. Moreover, it describes an experimental evaluation of the methodology that assessed gain in manual skills during training, transfer of procedural knowledge and manual skills in a final assessment, and changes in self-efficacy with three measurements over time (pre-training, post-training, and post-assessment). METHODS We implemented a VR application that supports the proposed methodology, and can thus be used with or without a mannequin. The experimental evaluation involved 30 participants who tried CPR in VR twice, performing two repetitions of 30 chest compressions per trial. Half participants tried the VR application with the mannequin and half without it. Final assessment required all participants to perform CPR on the mannequin without the assistance of VR. To assess self-efficacy, participants filled in a questionnaire at the three times of measurement. RESULTS Mixed-design ANOVAs showed effects of repetition, effects of group, or interaction between the two variables on manual skills assessed during training. In the final assessment, participants in both groups correctly remembered most of the steps of the procedure. ANOVAs revealed differences between the two groups only in pressure-related skills (better with mannequin) and in the number of wrong steps added to the procedure (better without mannequin). Mixed-design ANOVA showed a self-efficacy increase in both groups after training, which was maintained after final assessment. CONCLUSIONS The proposed VR methodology for CPR training has a positive effect on procedural knowledge, manual skills, and self-efficacy, with as well as without the physical mannequin. Trials on a mannequin are required to understand the correct pressure for chest compression. This supports the adoption of the proposed VR methodology to reduce instructor and mannequin time required to teach CPR to trainees.
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Affiliation(s)
- Fabio Buttussi
- Human-Computer Interaction Lab, Department of Mathematics, Computer Science, and Physics, University of Udine, Udine, Italy; SOC Istituto di Igiene ed Epidemiologia Clinica, Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy.
| | - Luca Chittaro
- Human-Computer Interaction Lab, Department of Mathematics, Computer Science, and Physics, University of Udine, Udine, Italy
| | - Francesca Valent
- SOC Istituto di Igiene ed Epidemiologia Clinica, Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy
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Derkenne C, Jost D, Roquet F, Dardel P, Kedzierewicz R, Mignon A, Travers S, Frattini B, Prieux L, Rozenberg E, Demaison X, Gaudet J, Charry F, Stibbe O, Briche F, Lemoine F, Lesaffre X, Maurin O, Gauyat E, Faraon E, Lemoine S, Prunet B. Mobile Smartphone Technology Is Associated With Out-of-hospital Cardiac Arrest Survival Improvement: The First Year "Greater Paris Fire Brigade" Experience. Acad Emerg Med 2020; 27:951-962. [PMID: 32445436 DOI: 10.1111/acem.13987] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Revised: 02/25/2020] [Accepted: 03/25/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND Out-of-hospital cardiac arrest (OHCA) remains associated with very high mortality. Accelerating the initiation of efficient cardiopulmonary resuscitation (CPR) is widely perceived as key to improving outcomes. The main goal was to determine whether identification and activation of nearby first responders through a smartphone application named Staying Alive (SA) can improve survival following OHCA in a large urban area (Paris). METHODS We conducted a nonrandomized cohort study of all adults with OHCA managed by the Greater Paris Fire Brigade during 2018, irrespective of mobile application usage. We compared survival data in cases where SA did or did not lead to the activation of nearby first responders. During dispatch, calls for OHCA were managed with or without SA. The intervention group included all cases where nearby first responders were successfully identified by SA and actively contributed to CPR. The control group included all other cases. We compared survival at hospital discharge between the intervention and control groups. We analyzed patient data, CPR metrics, and first responders' characteristics. RESULTS Approximately 4,107 OHCA cases were recorded in 2018. Among those, 320 patients were in the control group, whereas 46 patients, in the intervention group, received first responder-initiated CPR. After adjustment for confounders, survival at hospital discharge was significantly improved for patients in the intervention group (35% vs. 16%, adjusted odds ratio = 5.9, 95% confidence interval = 2.1 to 16.5, p < 0.001). All CPR metrics were improved in the intervention group. CONCLUSIONS We report that mobile smartphone technology was associated with OHCA survival through accelerated initiation of efficient CPR by first responders in a large urban area.
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Affiliation(s)
- Clément Derkenne
- From the Emergency Medical Department Paris Fire Brigade Paris France
| | - Daniel Jost
- From the Emergency Medical Department Paris Fire Brigade Paris France
- the Sudden Death Expertise Center Hôpital Pompidou Paris France
| | - Florian Roquet
- the Critical Care Department Hôpital Pompidou Paris France
- INSERM 1153 Unit Hôpital St Louis Paris France
| | - Paul Dardel
- Staying Alive Responder Endowment Fund Boulogne Billancourt France
| | | | - Alexandre Mignon
- Université Paris Descartes Paris France
- Hôpital Cochin 24 Assistance Publique–Hôpitaux de Paris Paris France
| | - Stéphane Travers
- From the Emergency Medical Department Paris Fire Brigade Paris France
- and the French Military Health Service Val de Grâce Military Academy Paris France
| | - Benoit Frattini
- From the Emergency Medical Department Paris Fire Brigade Paris France
| | - Laurent Prieux
- From the Emergency Medical Department Paris Fire Brigade Paris France
| | | | - Xavier Demaison
- From the Emergency Medical Department Paris Fire Brigade Paris France
| | - John Gaudet
- From the Emergency Medical Department Paris Fire Brigade Paris France
| | - Félicité Charry
- From the Emergency Medical Department Paris Fire Brigade Paris France
| | - Olivier Stibbe
- From the Emergency Medical Department Paris Fire Brigade Paris France
| | - Frédérique Briche
- From the Emergency Medical Department Paris Fire Brigade Paris France
| | - Frédéric Lemoine
- From the Emergency Medical Department Paris Fire Brigade Paris France
| | - Xavier Lesaffre
- From the Emergency Medical Department Paris Fire Brigade Paris France
| | - Olga Maurin
- From the Emergency Medical Department Paris Fire Brigade Paris France
| | - Eric Gauyat
- From the Emergency Medical Department Paris Fire Brigade Paris France
| | - Eric Faraon
- From the Emergency Medical Department Paris Fire Brigade Paris France
| | - Sabine Lemoine
- From the Emergency Medical Department Paris Fire Brigade Paris France
| | - Bertrand Prunet
- From the Emergency Medical Department Paris Fire Brigade Paris France
- and the French Military Health Service Val de Grâce Military Academy Paris France
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Hendrickx JO, van Gastel J, Leysen H, Martin B, Maudsley S. High-dimensionality Data Analysis of Pharmacological Systems Associated with Complex Diseases. Pharmacol Rev 2020; 72:191-217. [PMID: 31843941 DOI: 10.1124/pr.119.017921] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
It is widely accepted that molecular reductionist views of highly complex human physiologic activity, e.g., the aging process, as well as therapeutic drug efficacy are largely oversimplifications. Currently some of the most effective appreciation of biologic disease and drug response complexity is achieved using high-dimensionality (H-D) data streams from transcriptomic, proteomic, metabolomics, or epigenomic pipelines. Multiple H-D data sets are now common and freely accessible for complex diseases such as metabolic syndrome, cardiovascular disease, and neurodegenerative conditions such as Alzheimer's disease. Over the last decade our ability to interrogate these high-dimensionality data streams has been profoundly enhanced through the development and implementation of highly effective bioinformatic platforms. Employing these computational approaches to understand the complexity of age-related diseases provides a facile mechanism to then synergize this pathologic appreciation with a similar level of understanding of therapeutic-mediated signaling. For informative pathology and drug-based analytics that are able to generate meaningful therapeutic insight across diverse data streams, novel informatics processes such as latent semantic indexing and topological data analyses will likely be important. Elucidation of H-D molecular disease signatures from diverse data streams will likely generate and refine new therapeutic strategies that will be designed with a cognizance of a realistic appreciation of the complexity of human age-related disease and drug effects. We contend that informatic platforms should be synergistic with more advanced chemical/drug and phenotypic cellular/tissue-based analytical predictive models to assist in either de novo drug prioritization or effective repurposing for the intervention of aging-related diseases. SIGNIFICANCE STATEMENT: All diseases, as well as pharmacological mechanisms, are far more complex than previously thought a decade ago. With the advent of commonplace access to technologies that produce large volumes of high-dimensionality data (e.g., transcriptomics, proteomics, metabolomics), it is now imperative that effective tools to appreciate this highly nuanced data are developed. Being able to appreciate the subtleties of high-dimensionality data will allow molecular pharmacologists to develop the most effective multidimensional therapeutics with effectively engineered efficacy profiles.
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Affiliation(s)
- Jhana O Hendrickx
- Receptor Biology Laboratory, Department of Biomedical Research (J.O.H., J.v.G., H.L., S.M.) and Faculty of Pharmacy, Biomedical and Veterinary Sciences (J.O.H., J.v.G., H.L., B.M., S.M.), University of Antwerp, Antwerp, Belgium
| | - Jaana van Gastel
- Receptor Biology Laboratory, Department of Biomedical Research (J.O.H., J.v.G., H.L., S.M.) and Faculty of Pharmacy, Biomedical and Veterinary Sciences (J.O.H., J.v.G., H.L., B.M., S.M.), University of Antwerp, Antwerp, Belgium
| | - Hanne Leysen
- Receptor Biology Laboratory, Department of Biomedical Research (J.O.H., J.v.G., H.L., S.M.) and Faculty of Pharmacy, Biomedical and Veterinary Sciences (J.O.H., J.v.G., H.L., B.M., S.M.), University of Antwerp, Antwerp, Belgium
| | - Bronwen Martin
- Receptor Biology Laboratory, Department of Biomedical Research (J.O.H., J.v.G., H.L., S.M.) and Faculty of Pharmacy, Biomedical and Veterinary Sciences (J.O.H., J.v.G., H.L., B.M., S.M.), University of Antwerp, Antwerp, Belgium
| | - Stuart Maudsley
- Receptor Biology Laboratory, Department of Biomedical Research (J.O.H., J.v.G., H.L., S.M.) and Faculty of Pharmacy, Biomedical and Veterinary Sciences (J.O.H., J.v.G., H.L., B.M., S.M.), University of Antwerp, Antwerp, Belgium
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Ming Ng W, De Souza CR, Pek PP, Shahidah N, Ng YY, Arulanandam S, White AE, Leong BSH, Ong MEH. myResponder Smartphone Application to Crowdsource Basic Life Support for Out-of-Hospital Cardiac Arrest: The Singapore Experience. PREHOSP EMERG CARE 2020; 25:388-396. [PMID: 32497484 DOI: 10.1080/10903127.2020.1777233] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
OBJECTIVE The Singapore myResponder is a novel smartphone application developed by the Singapore Civil Defence Force (SCDF) that notifies volunteer first responders of a suspected out-of-hospital cardiac arrest (OHCA) case and locations of Automated External Defibrillators (AED) in the vicinity so that they can assist with resuscitation. We aimed to examine the performance of this application, challenges encountered, and future directions. Methods: We analyzed data from the myResponder app since its launch from April 2015 to July 2019. The number of installations, registered community first responders, suspected OHCA cases, notifications sent by the app, percentage of responders who accepted activation and arrived at scene were reviewed. A subgroup of taxi driving responders (within a 1.5-kilometer response radius) carrying an AED under a subsequent pilot program was also analyzed. Results: By July 2019, 46,689 responders were registered in the myResponder app. There were a total of 19,189 cases created for suspected OHCA, with a median of 358 cases per month (IQR 330-430), in which 10,073 responders accepted activation from myResponder and 4,955 arrived on-scene. A total of 135,599 notifications were sent for these cases, with a median of 7.1 notifications per case (IQR 4.3-8.7). In 2019, the percentages of responders who accepted notification and arrived on scene were 45.8% and 24.1%, respectively. 43% (1110/2581) of responders arrived before EMS crew. Conclusion: The myResponder mobile application is a feasible smart technology solution to improve community response to OHCA, and to increase bystander CPR and AED use. Future directions include increasing the number of active responders, improving response rates, app performance, and better data capture for quality improvement.
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Young SD, Wang W, Chakravarthy B. Crowdsourced Traffic Data as an Emerging Tool to Monitor Car Crashes. JAMA Surg 2020; 154:777-778. [PMID: 31116356 DOI: 10.1001/jamasurg.2019.1167] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Sean D Young
- Department of Family Medicine, University of California, Los Angeles.,Department of Emergency Medicine, University of California, Irvine, School of Medicine, Irvine.,University of California Institute for Prediction Technology, Department of Informatics, Donald Bren School of Information and Computer Sciences, University of California, Irvine
| | - Wei Wang
- Department of Computer Science, Henry Samueli School of Engineering, University of California, Los Angeles
| | - Bharath Chakravarthy
- Department of Emergency Medicine, University of California, Irvine, School of Medicine, Irvine
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Improving response to out-of-hospital cardiac arrest: The verified responder program pilot. Resuscitation 2020; 154:1-6. [PMID: 32580006 DOI: 10.1016/j.resuscitation.2020.06.015] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Revised: 06/03/2020] [Accepted: 06/10/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND Survival following out-of-hospital cardiac arrest (OHCA) decreases as the interval from collapse to CPR and defibrillation increases. Innovative approaches are needed to reduce response intervals, especially for private locations. METHODS We undertook the Verified Responder Program in 5 United States communities during 2018, whereby off-duty EMS professionals volunteered and were equipped with automated external defibrillators (AEDs). Volunteers were alerted using a geospatial smartphone application (PulsePoint) and could respond to nearby private and public suspected OHCA. The study evaluated the frequency of Verified Responder notification, response, scene arrival, and initial care prior to EMS arrival. OHCA surveillance used the CARES registry. RESULTS Of the 651 OHCA events (475 private, 176 public), Verified Responders were notified in 7.4% (n = 49). Among the 475 in a private location, volunteers were alerted in 8% (n = 38), responded in 2.7% (n = 13), arrived on scene in 2.3% (n = 11), and provided initial care in 1.7% (n = 8). Among the 176 in a public location, volunteers were alerted in 6.3% (n = 11), responded in 2.3% (n = 4), arrived on-scene in 2.3% (n = 4), and provided initial care in 2.3% (n = 4). Over 96% surveyed had positive impression of the program and intended to continue participation. No responder reported any adverse event. CONCLUSIONS In this initial US-based experience of a smartphone program for suspected OHCA in private and public locations, Verified Responders reported a positive experience, though were only involved in a small fraction of OHCA. Studies should determine how this type of program could be enhanced to involve more OHCA events.
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Fernández-Méndez F, Barcala-Furelos R, Otero-Agra M, Fernández-Méndez M, Santos-Folgar M, Rodríguez-Núñez A. Evaluación sobre la técnica de compresiones torácicas usando APP. ¿Ayudan o entorpecen la reanimación cardiopulmonar? Med Intensiva 2020; 44:72-79. [DOI: 10.1016/j.medin.2018.07.015] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2018] [Revised: 06/01/2018] [Accepted: 07/16/2018] [Indexed: 11/25/2022]
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Shao M, Lin X, Jiang D, Tian H, Xu Y, Wang L, Ji F, Zhou C, Song X, Zhuo C. Depression and cardiovascular disease: Shared molecular mechanisms and clinical implications. Psychiatry Res 2020; 285:112802. [PMID: 32036152 DOI: 10.1016/j.psychres.2020.112802] [Citation(s) in RCA: 50] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Revised: 01/19/2020] [Accepted: 01/19/2020] [Indexed: 12/13/2022]
Abstract
Depression is a highly prevalent risk factor for both the onset of cardiovascular disease (CVD) and the mortality of CVD patients, and people suffering from CVD are more likely to develop depression than healthy individuals. The aim of this review is to summarize recent findings regarding the underlying relationship between CVD and depression. Literature search and review were conducted using PubMed, Google Scholar, Wanfang Med Online, and Baidu Scholar databases. CVD and depression are intimately related and researchers from around the world have proposed and validated various mechanisms that may potentially explain the comorbidity of CVD and depression. Recent studies have suggested that depression and CVD may manifest as two distinct clinical conditions in two different organs, the brain and the heart, respectively, but may also be linked by shared mechanisms. Of these, inflammation involving the immune system is thought to be a common mechanism of depression and heart disease, with specific inflammatory cytokines or pathways being potential targets for the prevention and treatment of the concurrent diseases. Therefore, inflammation may play an important role in bridging the link between depression and CVD, a finding that can have important clinical implications for the prevention and early intervention of these conditions.
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Affiliation(s)
- Mingjing Shao
- National Integrated Traditional and Western Medicine Center for Cardivascular Disease, China-Japan Friendship Hospital, Beijing 100101, China
| | - Xiaodong Lin
- Department of Psychiatric-Neuroimaging-Genetics Laboratory (PNG_Lab), Wenzhou Seventh People's Hospital, Wenzhou, Zhejiang Province 325000, China
| | - Deguo Jiang
- Department of Psychiatric-Neuroimaging-Genetics Laboratory (PNG_Lab), Wenzhou Seventh People's Hospital, Wenzhou, Zhejiang Province 325000, China
| | - Hongjun Tian
- PNGC-Lab, Tianjin Mental Health Centre, Tianjin Anding Hospital, Tianjin, 300222, China
| | - Yong Xu
- Department of Psychiatry, First Hospital of Shanxi Medical University, Tainyuan, 030001, China
| | - Lina Wang
- PNGC-Lab, Tianjin Mental Health Centre, Tianjin Anding Hospital, Tianjin, 300222, China
| | - Feng Ji
- Department of Psychiatry, School of Mental Health, Jining Medical University, Jining, Shandong Province 272100, China
| | - Chunhua Zhou
- Department of Pharmacology, The first Hospital of Hebei Medical University, Shijiazhuang, Hebei Province 37000,China
| | - Xueqing Song
- Department of Psychiatry, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450000, China
| | - Chuanjun Zhuo
- Department of Psychiatry, School of Mental Health, Jining Medical University, Jining, Shandong Province 272100, China; Department of Psychiatric-Neuroimaging-Genetics Laboratory (PNG_Lab), Wenzhou Seventh People's Hospital, Wenzhou, Zhejiang Province 325000, China; Department of Psychiatry, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450000, China; Department of Psychiatry, First Hospital of Shanxi Medical University, Tainyuan, 030001, China.
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Crowdsourcing in health and medical research: a systematic review. Infect Dis Poverty 2020; 9:8. [PMID: 31959234 PMCID: PMC6971908 DOI: 10.1186/s40249-020-0622-9] [Citation(s) in RCA: 64] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2019] [Accepted: 01/07/2020] [Indexed: 12/31/2022] Open
Abstract
Background Crowdsourcing is used increasingly in health and medical research. Crowdsourcing is the process of aggregating crowd wisdom to solve a problem. The purpose of this systematic review is to summarize quantitative evidence on crowdsourcing to improve health. Methods We followed Cochrane systematic review guidance and systematically searched seven databases up to September 4th 2019. Studies were included if they reported on crowdsourcing and related to health or medicine. Studies were excluded if recruitment was the only use of crowdsourcing. We determined the level of evidence associated with review findings using the GRADE approach. Results We screened 3508 citations, accessed 362 articles, and included 188 studies. Ninety-six studies examined effectiveness, 127 examined feasibility, and 37 examined cost. The most common purposes were to evaluate surgical skills (17 studies), to create sexual health messages (seven studies), and to provide layperson cardio-pulmonary resuscitation (CPR) out-of-hospital (six studies). Seventeen observational studies used crowdsourcing to evaluate surgical skills, finding that crowdsourcing evaluation was as effective as expert evaluation (low quality). Four studies used a challenge contest to solicit human immunodeficiency virus (HIV) testing promotion materials and increase HIV testing rates (moderate quality), and two of the four studies found this approach saved money. Three studies suggested that an interactive technology system increased rates of layperson initiated CPR out-of-hospital (moderate quality). However, studies analyzing crowdsourcing to evaluate surgical skills and layperson-initiated CPR were only from high-income countries. Five studies examined crowdsourcing to inform artificial intelligence projects, most often related to annotation of medical data. Crowdsourcing was evaluated using different outcomes, limiting the extent to which studies could be pooled. Conclusions Crowdsourcing has been used to improve health in many settings. Although crowdsourcing is effective at improving behavioral outcomes, more research is needed to understand effects on clinical outcomes and costs. More research is needed on crowdsourcing as a tool to develop artificial intelligence systems in medicine. Trial registration PROSPERO: CRD42017052835. December 27, 2016.
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Ukoha C, Stranieri A. Criteria to Measure Social Media Value in Health Care Settings: Narrative Literature Review. J Med Internet Res 2019; 21:e14684. [PMID: 31841114 PMCID: PMC6937544 DOI: 10.2196/14684] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Revised: 08/03/2019] [Accepted: 08/20/2019] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND With the growing use of social media in health care settings, there is a need to measure outcomes resulting from its use to ensure continuous performance improvement. Despite the need for measurement, a unified approach for measuring the value of social media used in health care remains elusive. OBJECTIVE This study aimed to elucidate how the value of social media in health care settings can be ascertained and to taxonomically identify steps and techniques in social media measurement from a review of relevant literature. METHODS A total of 65 relevant articles drawn from 341 articles on the subject of measuring social media in health care settings were qualitatively analyzed and synthesized. The articles were selected from the literature from diverse disciplines including business, information systems, medical informatics, and medicine. RESULTS The review of the literature showed different levels and focus of analysis when measuring the value of social media in health care settings. It equally showed that there are various metrics for measurement, levels of measurement, approaches to measurement, and scales of measurement. Each may be relevant, depending on the use case of social media in health care. CONCLUSIONS A comprehensive yardstick is required to simplify the measurement of outcomes resulting from the use of social media in health care. At the moment, there is neither a consensus on what indicators to measure nor on how to measure them. We hope that this review is used as a starting point to create a comprehensive measurement criterion for social media used in health care.
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Affiliation(s)
- Chukwuma Ukoha
- Centre for Informatics and Applied Optimisation, Federation University Australia, Ballarat, Australia
| | - Andrew Stranieri
- Centre for Informatics and Applied Optimisation, Federation University Australia, Ballarat, Australia
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Affiliation(s)
- William J Brady
- From the Department of Emergency Medicine, University of Virginia Health System, Albemarle County Fire Rescue, Charlottesville (W.J.B.); the Department of Emergency Medicine, University of Maryland School of Medicine, Baltimore (A.M.); and the Department of Emergency Medicine, Vanderbilt University Medical Center, the Metro Nashville Fire Department, and the Nashville International Airport Department of Public Safety - all in Nashville (C.M.S.)
| | - Amal Mattu
- From the Department of Emergency Medicine, University of Virginia Health System, Albemarle County Fire Rescue, Charlottesville (W.J.B.); the Department of Emergency Medicine, University of Maryland School of Medicine, Baltimore (A.M.); and the Department of Emergency Medicine, Vanderbilt University Medical Center, the Metro Nashville Fire Department, and the Nashville International Airport Department of Public Safety - all in Nashville (C.M.S.)
| | - Corey M Slovis
- From the Department of Emergency Medicine, University of Virginia Health System, Albemarle County Fire Rescue, Charlottesville (W.J.B.); the Department of Emergency Medicine, University of Maryland School of Medicine, Baltimore (A.M.); and the Department of Emergency Medicine, Vanderbilt University Medical Center, the Metro Nashville Fire Department, and the Nashville International Airport Department of Public Safety - all in Nashville (C.M.S.)
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Oteir AO, Almhdawi KA, Kanaan SF, Alwidyan MT, Williams B. Cardiopulmonary resuscitation level of knowledge among allied health university students in Jordan: a cross-sectional study. BMJ Open 2019; 9:e031725. [PMID: 31748305 PMCID: PMC6887078 DOI: 10.1136/bmjopen-2019-031725] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Revised: 10/28/2019] [Accepted: 11/01/2019] [Indexed: 01/11/2023] Open
Abstract
OBJECTIVE To explore the level of cardiopulmonary resuscitation (CPR) knowledge among allied health professions (AHPs) students and its associated factors. METHODS This is a cross-sectional study assessing CPR knowledge among AHP students. A multidisciplinary expert panel designed a survey, which then was piloted to 20 potential participants. The survey had two sections, including demographics and knowledge questions. Knowledge questions scores ranged from 0 to 10, where 10 indicates all questions were answered correctly. RESULTS A total of 883 students completed the surveys and were included in the study. The mean age was 21 years (±1.6) and the majority were females (73.1%). A total of 693 (78.5%) students did not receive previous CPR training and the top barriers to receiving CPR training were unawareness of training opportunities and a lack of time. Participants had a mean CPR knowledge score of 3.9 (±1.7) out of 10 maximum potential points. Trained participants had a higher mean score compared with the untrained (4.6 (±1.6) vs 3.8 (±1.6), p<0.001). Previous training (adjusted β=0.6; 95% CI 0.2 to 0.9; p<0.001) and being in the physical therapy programme (adjusted β=0.5; 95% CI 0.1 to 0.8; p=0.01) were associated with higher knowledge. CONCLUSION There is poor knowledge of CPR among AHP students including trained individuals. Efforts to increase the awareness of CPR should target students and professionals who are highly likely to encounter patients requiring CPR. Compulsory training courses, shorter training periods as well as recurrent and regular refreshing courses and use of various media devices are recommended.
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Affiliation(s)
- Alaa O Oteir
- Allied Medical Sciences, Jordan University of Science and Technology, Irbid, Jordan
- Community Emergency Health and Paramedic Practice, Monash University, Frankston, Victoria, Australia
| | - Khader A Almhdawi
- Rehabilitation Sciences, Jordan University of Science and Technology, Irbid, Jordan
| | - Saddam F Kanaan
- Rehabilitation Sciences, Jordan University of Science and Technology, Irbid, Jordan
| | - Mahmoud T Alwidyan
- Allied Medical Sciences, Jordan University of Science and Technology, Irbid, Jordan
| | - Brett Williams
- Community Emergency Health and Paramedic Practice, Monash University, Frankston, Victoria, Australia
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Zhu J, Hou W, Xu Y, Ji F, Wang G, Chen C, Lin C, Lin X, Li J, Zhuo C, Shao M. Antipsychotic drugs and sudden cardiac death: A literature review of the challenges in the prediction, management, and future steps. Psychiatry Res 2019; 281:112598. [PMID: 31622875 DOI: 10.1016/j.psychres.2019.112598] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Revised: 10/02/2019] [Accepted: 10/02/2019] [Indexed: 12/14/2022]
Abstract
Sudden cardiac death (SCD) is relatively uncommon, yet it is a deadly consequence of some antipsychotic medications in patients with psychiatric disorders. The widespread concerns about the adverse cardiac effects associated with antipsychotics and their unpredictable nature have led to a restriction on the use of some antipsychotic medications. Recent progress has been made in the identification of important genetic factors that may contribute to the adverse complication of antipsychotic drugs, suggesting that high-risk individuals can be identified prior to initiating therapy. In addition, some high-tech smart wearable medical devices have recently been developed, allowing users to record and analyze the electrocardiogram (ECG) in couple with artificial intelligence (AI) technologies, and notifying of irregular heart rhythms or arrhythmias, a medical condition well documented in most SCD cases. In this literature review, we summarize recent advances in understanding the link between SCD and antipsychotic drug usage, as well as in utilizing wearable medical devices for monitoring of cardiac arrhythmias. New strategies for improving the care of patients receiving antipsychotic medications are proposed. As it is now possible to evaluate the risk of SCD in patients on antipsychotic medications, preventative measures and close monitoring may be used to detect the early signs of adverse cardiac events and SCD.
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Affiliation(s)
- Jingjing Zhu
- Department of Psychiatry, Wenzhou Seventh People's Hospital, Wenzhou, Zhejiang, 325000, China
| | - Weihong Hou
- Department of Biochemistry and Molecular Biology, Zhengzhou University, Zhengzhou, Henan, 450001, China
| | - Yong Xu
- Department of Psychiatry, First Hospital/First Clinical Medical College of Shanxi Medical University, Taiyuan, China,; MDT Center for Cognitive Impairment and Sleep Disorders, First Hospital of Shanxi Medical University, Taiyuan, China; National Key Disciplines, Key Laboratory for Cellular Physiology, Ministry of Education, Department of Neurobiology, Shanxi Medical University, Taiyuan, Shanxi 030001, China
| | - Feng Ji
- Department of Psychiatry, School of Mental Health, Psychiatric Genetics Laboratory (PSYG-Lab), Jining Medical University, Jining, Shandong, 272191, China
| | - Guowei Wang
- Department of Psychiatry, Linyi Mental Health Center, Linyi, Shandong, 271000, China
| | - Ce Chen
- Department of Psychiatry, Wenzhou Seventh People's Hospital, Wenzhou, Zhejiang, 325000, China
| | - Chongguang Lin
- Department of Psychiatry, Wenzhou Seventh People's Hospital, Wenzhou, Zhejiang, 325000, China
| | - Xiodong Lin
- Department of Psychiatry, Wenzhou Seventh People's Hospital, Wenzhou, Zhejiang, 325000, China
| | - Jie Li
- Department of Psychiatric-Neuroimaging-Genetics and Morbidity Laboratory (PNGC-Lab), Nankai University Affiliated Anding Hospital, Tianjin Mental Health Center, Mental Health Teaching Hospital, Tianjin Medical University, Tianjin 300222, China
| | - Chuanjun Zhuo
- Department of Psychiatry, School of Mental Health, Psychiatric Genetics Laboratory (PSYG-Lab), Jining Medical University, Jining, Shandong, 272191, China; Department of Psychiatry, Wenzhou Seventh People's Hospital, Wenzhou, Zhejiang, 325000, China; Department of Biochemistry and Molecular Biology, Zhengzhou University, Zhengzhou, Henan, 450001, China; Department of Psychiatric-Neuroimaging-Genetics and Morbidity Laboratory (PNGC-Lab), Nankai University Affiliated Anding Hospital, Tianjin Mental Health Center, Mental Health Teaching Hospital, Tianjin Medical University, Tianjin 300222, China; Department of China-Canada Biological Psychiatry Lab, Xiamen Xianyue Hospital, Xiamen, Fujian, 361000, China
| | - Mingjng Shao
- National Integrated Traditional and Western Medicine Center for Cardiovascular Disease, China-Japan Friendship Hospital, Beijing, 100029, China
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Koo K, Aro T, Matlaga BR. Rapid, Efficient Crowdsourcing Using Social Media for the Surgical Management of Nephrolithiasis. J Endourol 2019; 33:872-876. [DOI: 10.1089/end.2019.0481] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Kevin Koo
- Department of Urology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Tareq Aro
- Department of Urology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Brian R. Matlaga
- Department of Urology, Johns Hopkins University School of Medicine, Baltimore, Maryland
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Kern KB, Colberg TP, Wunder C, Newton C, Slepian MJ. A local neighborhood volunteer network improves response times for simulated cardiac arrest. Resuscitation 2019; 144:131-136. [PMID: 31580910 DOI: 10.1016/j.resuscitation.2019.09.016] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Revised: 09/09/2019] [Accepted: 09/16/2019] [Indexed: 11/17/2022]
Abstract
AIM Each minute is crucial in the treatment of out-of-hospital cardiac arrest (CA). Immediate chest compressions and early defibrillation are keys to good outcomes. We hypothesized that a coordinated effort of alerting trained local neighborhood volunteers (vols) simultaneously with 911 activation of professional EMS providers would result in substantial decreases in call-to-arrival times, leading to earlier CPR and defibrillation. METHODS We developed a program of simultaneously alerting CPR- and AED-trained neighborhood vols and the local EMS system for CA events in a retirement residential neighborhood in Southern Arizona, encompassing approximately 440 homes. The closest EMS station is 3.3 miles from this neighborhood. Within this neighborhood, 15 vols and the closest EMS station were involved in multiple days of mock CA notifications and responses. RESULTS The two groups differed significantly in distance to the mock CA event and in response times. The volunteers averaged 0.3 ± 0.2 miles from the mock CA incidences while the closest EMS station averaged 3.4 ± 0.1 miles away (p < 0.0001). Response times (time from call to arrival) also differed. Two volunteers, one bringing an AED, averaged 1 min 38 s ± 53 s in Phase 1, while it took the EMS service an average of 7 min 20 s ± 1 min 13 s to arrive on scene; p < 0.0001. CONCLUSION Local neighborhood volunteers were geographically closer and arrived significantly sooner at the mock CA scene than did the EMS service. The approximate time savings from call to arrival with the volunteers was 4-6 min.
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Affiliation(s)
- K B Kern
- Sarver Heart Center, University of Arizona, Tucson, AZ, United States.
| | | | - C Wunder
- Green Valley Fire Department, Green Valley, AZ, United States
| | - C Newton
- Cardiospark LLC, Tucson, AZ, United States
| | - M J Slepian
- Sarver Heart Center, University of Arizona, Tucson, AZ, United States
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Cheng A, Nadkarni VM, Mancini MB, Hunt EA, Sinz EH, Merchant RM, Donoghue A, Duff JP, Eppich W, Auerbach M, Bigham BL, Blewer AL, Chan PS, Bhanji F. Resuscitation Education Science: Educational Strategies to Improve Outcomes From Cardiac Arrest: A Scientific Statement From the American Heart Association. Circulation 2019; 138:e82-e122. [PMID: 29930020 DOI: 10.1161/cir.0000000000000583] [Citation(s) in RCA: 189] [Impact Index Per Article: 37.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
The formula for survival in resuscitation describes educational efficiency and local implementation as key determinants in survival after cardiac arrest. Current educational offerings in the form of standardized online and face-to-face courses are falling short, with providers demonstrating a decay of skills over time. This translates to suboptimal clinical care and poor survival outcomes from cardiac arrest. In many institutions, guidelines taught in courses are not thoughtfully implemented in the clinical environment. A current synthesis of the evidence supporting best educational and knowledge translation strategies in resuscitation is lacking. In this American Heart Association scientific statement, we provide a review of the literature describing key elements of educational efficiency and local implementation, including mastery learning and deliberate practice, spaced practice, contextual learning, feedback and debriefing, assessment, innovative educational strategies, faculty development, and knowledge translation and implementation. For each topic, we provide suggestions for improving provider performance that may ultimately optimize patient outcomes from cardiac arrest.
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Gabizon I, Bhagirath V, Lokker C, Bhavnani SP, Lonn E. What do physicians need to know in order to 'prescribe' mobile applications to patients with cardiovascular disease? Per Med 2019; 16:263-268. [PMID: 31313642 DOI: 10.2217/pme-2019-0015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Affiliation(s)
- Itzhak Gabizon
- Department of Cardiology, Soroka University Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Vinai Bhagirath
- Department of Medicine, McMaster University, Hamilton, ON, L8S 4L8, Canada.,Thrombosis & Atherosclerosis Research Institute, Hamilton, ON, L8L 2X2, Canada
| | - Cynthia Lokker
- Health Information Research Unit, Department of Health Research Methods, Evidence, & Impact, McMaster University, Hamilton, ON, L8S 4L8, Canada
| | - Sanjeev P Bhavnani
- Prebys Cardiovascular Institute, Healthcare Innovation & Practice Transformation Laboratory, Scripps Clinic, La Jolla, CA 92037, USA
| | - Eva Lonn
- Department of Medicine, McMaster University, Hamilton, ON, L8S 4L8, Canada
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Bylow H, Karlsson T, Lepp M, Claesson A, Lindqvist J, Herlitz J. Effectiveness of web-based education in addition to basic life support learning activities: A cluster randomised controlled trial. PLoS One 2019; 14:e0219341. [PMID: 31295275 PMCID: PMC6622500 DOI: 10.1371/journal.pone.0219341] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Accepted: 06/23/2019] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Effective education in basic life support (BLS) may improve the early initiation of high-quality cardiopulmonary resuscitation and automated external defibrillation (CPR-AED). AIM To compare the learning outcome in terms of practical skills and knowledge of BLS after participating in learning activities related to BLS, with and without web-based education in cardiovascular diseases (CVD). METHODS Laymen (n = 2,623) were cluster randomised to either BLS education or to web-based education in CVD before BLS training. The participants were assessed by a questionnaire for theoretical knowledge and then by a simulated scenario for practical skills. The total score for practical skills in BLS six months after training was the primary outcome. The total score for practical skills directly after training, separate variables and self-assessed knowledge, confidence and willingness, directly and six months after training, were the secondary outcomes. RESULTS BLS with web-based education was more effective than BLS without web-based education and obtained a statistically significant higher total score for practical skills at six months (mean 58.8, SD 5.0 vs mean 58.0, SD 5.0; p = 0.03) and directly after training (mean 59.6, SD 4.8 vs mean 58.7, SD 4.9; p = 0.004). CONCLUSION A web-based education in CVD in addition to BLS training enhanced the learning outcome with a statistically significant higher total score for performed practical skills in BLS as compared to BLS training alone. However, in terms of the outcomes, the differences were minor, and the clinical relevance of our findings has a limited practical impact.
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Affiliation(s)
- Helene Bylow
- Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Thomas Karlsson
- Health Metrics Unit, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Margret Lepp
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Østfold University College, Halden, Norway
- School of Nursing and Midwifery, Griffith University, Brisbane, Australia
| | - Andreas Claesson
- Department of Medicine, Centre for Resuscitation Science, Karolinska Institute, Stockholm, Sweden
| | | | - Johan Herlitz
- Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Centre of Registers Västra Götaland, Gothenburg, Sweden
- Prehospen-Centre of Prehospital Research; Faculty of Caring Science, Work Life and Social Welfare; University of Borås, Borås, Sweden
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Martinez-Gutierrez JC, Chandra RV, Hirsch JA, Leslie-Mazwi T. Technological innovation for prehospital stroke triage: ripe for disruption. J Neurointerv Surg 2019; 11:1085-1090. [DOI: 10.1136/neurintsurg-2019-014902] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2019] [Revised: 05/21/2019] [Accepted: 05/22/2019] [Indexed: 12/19/2022]
Abstract
BackgroundWith the benefit of mechanical thrombectomy firmly established, the focus has shifted to improved delivery of care. Reducing time from symptom onset to reperfusion is a primary goal. Technology promises tremendous opportunities in the prehospital space to achieve this goal.MethodsThis review explores existing, fledgling, and potential future technologies for application in the prehospital space.ResultsThe opportunity for technology to improve stroke care resides in the detection, evaluation, triage, and transport of patients to an appropriate healthcare facility. Most prehospital technology remains in the early stages of design and implementation.ConclusionThe major challenges to tackle for future improvement in prehospital stroke care are that of public awareness, emergency medical service detection, and triage, and improved systems of stroke care. Thoughtfully applied technology will transform all these areas.
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2017 Roadmap for Innovation-ACC Health Policy Statement on Healthcare Transformation in the Era of Digital Health, Big Data, and Precision Health: A Report of the American College of Cardiology Task Force on Health Policy Statements and Systems of Care. J Am Coll Cardiol 2019; 70:2696-2718. [PMID: 29169478 DOI: 10.1016/j.jacc.2017.10.018] [Citation(s) in RCA: 70] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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Adeoye O, Nyström KV, Yavagal DR, Luciano J, Nogueira RG, Zorowitz RD, Khalessi AA, Bushnell C, Barsan WG, Panagos P, Alberts MJ, Tiner AC, Schwamm LH, Jauch EC. Recommendations for the Establishment of Stroke Systems of Care: A 2019 Update. Stroke 2019; 50:e187-e210. [PMID: 31104615 DOI: 10.1161/str.0000000000000173] [Citation(s) in RCA: 225] [Impact Index Per Article: 45.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
In 2005, the American Stroke Association published recommendations for the establishment of stroke systems of care and in 2013 expanded on them with a statement on interactions within stroke systems of care. The aim of this policy statement is to provide a comprehensive review of the scientific evidence evaluating stroke systems of care to date and to update the American Stroke Association recommendations on the basis of improvements in stroke systems of care. Over the past decade, stroke systems of care have seen vast improvements in endovascular therapy, neurocritical care, and stroke center certification, in addition to the advent of innovations, such as telestroke and mobile stroke units, in the context of significant changes in the organization of healthcare policy in the United States. This statement provides an update to prior publications to help guide policymakers and public healthcare agencies in continually updating their stroke systems of care in light of these changes. This statement and its recommendations span primordial and primary prevention, acute stroke recognition and activation of emergency medical services, triage to appropriate facilities, designation of and treatment at stroke centers, secondary prevention at hospital discharge, and rehabilitation and recovery.
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Leary M, McGovern SK, Chaudhary Z, Patel J, Abella BS, Blewer AL. Comparing bystander response to a sudden cardiac arrest using a virtual reality CPR training mobile app versus a standard CPR training mobile app. Resuscitation 2019; 139:167-173. [PMID: 31005588 DOI: 10.1016/j.resuscitation.2019.04.017] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Revised: 03/27/2019] [Accepted: 04/10/2019] [Indexed: 10/27/2022]
Abstract
BACKGROUND Using a mobile virtual reality (VR) platform to heighten realism for cardiopulmonary resuscitation (CPR) training has the potential to improve bystander response. OBJECTIVES We examined whether using a VR mobile application (mApp) for CPR training would improve bystander response compared with a standard mApp CPR training. METHODS We randomized lay bystanders to either our intervention arm (VR mApp) or our control arm (mApp). During a post-intervention skills test, we collected bystander response data (call 911, perform CPR, ask for an automated external defibrillator (AED)), along with CPR quality (chest compression (CC) rate and depth). Wilcox rank sum was used to analyze CC rate and CC depth as they were not normally distributed; Pearson's Chi-square was used to analyze Chain of Survival variables. RESULTS Between 3/2018 and 9/2018, 105 subjects were enrolled: 52 VR mApp and 53 mApp. Mean age was 46 ± 16 years, 34% were female, 59% were Black, and 17% were currently CPR trained (≤2 years). Bystander response was significantly higher in the VR mApp arm: called 911 (82% vs 58%, p = 0.007) and asked for an AED (57% vs 28%, p = 0.003). However there was no difference in CPR performed (98% vs 98%, p = NS) and the application of the AED (90% vs 93%, p = NS). When comparing the VR mApp to the mApp, mean CC rate was 104 ± 42 cpm vs 112 ± 30 cpm (p = NS), and mean CC depth was 38 ± 15 mm vs 44 ± 13 mm (p = 0.05). CONCLUSION The use of the VR mApp significantly increased the likelihood of calling 911 and asking for an AED, however, CC depth was decreased.
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Affiliation(s)
- Marion Leary
- Center for Resuscitation Science and Department of Emergency Medicine, Department of Emergency Medicine, University of Pennsylvania Perelman School of Medicine, United States; School of Nursing, University of Pennsylvania, Philadelphia, PA, United States.
| | - Shaun K McGovern
- Center for Resuscitation Science and Department of Emergency Medicine, Department of Emergency Medicine, University of Pennsylvania Perelman School of Medicine, United States; School of Nursing, University of Pennsylvania, Philadelphia, PA, United States
| | - Zainab Chaudhary
- Center for Resuscitation Science and Department of Emergency Medicine, Department of Emergency Medicine, University of Pennsylvania Perelman School of Medicine, United States; School of Nursing, University of Pennsylvania, Philadelphia, PA, United States; Department of Family Medicine and Community Health, Duke University, Durham, NC, United States
| | - Jaldhi Patel
- Center for Resuscitation Science and Department of Emergency Medicine, Department of Emergency Medicine, University of Pennsylvania Perelman School of Medicine, United States; School of Nursing, University of Pennsylvania, Philadelphia, PA, United States; Department of Family Medicine and Community Health, Duke University, Durham, NC, United States
| | - Benjamin S Abella
- Center for Resuscitation Science and Department of Emergency Medicine, Department of Emergency Medicine, University of Pennsylvania Perelman School of Medicine, United States
| | - Audrey L Blewer
- Center for Resuscitation Science and Department of Emergency Medicine, Department of Emergency Medicine, University of Pennsylvania Perelman School of Medicine, United States; Department of Family Medicine and Community Health, Duke University, Durham, NC, United States
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Ventricular fibrillation recorded and analysed within an area the size of a mobile phone: could it enable cardiac arrest recognition? Eur J Emerg Med 2018; 25:394-399. [DOI: 10.1097/mej.0000000000000473] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Real-Time Chest Compression Quality Measurements by Smartphone Camera. JOURNAL OF HEALTHCARE ENGINEERING 2018; 2018:6241856. [PMID: 30581549 PMCID: PMC6277120 DOI: 10.1155/2018/6241856] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Accepted: 07/18/2018] [Indexed: 12/11/2022]
Abstract
Out-of-hospital cardiac arrest (OHCA) is recognized as a global mortality challenge, and digital strategies could contribute to increase the chance of survival. In this paper, we investigate if cardiopulmonary resuscitation (CPR) quality measurement using smartphone video analysis in real-time is feasible for a range of conditions. With the use of a web-connected smartphone application which utilizes the smartphone camera, we detect inactivity and chest compressions and measure chest compression rate with real-time feedback to both the caller who performs chest compressions and over the web to the dispatcher who coaches the caller on chest compressions. The application estimates compression rate with 0.5 s update interval, time to first stable compression rate (TFSCR), active compression time (TC), hands-off time (TWC), average compression rate (ACR), and total number of compressions (NC). Four experiments were performed to test the accuracy of the calculated chest compression rate under different conditions, and a fifth experiment was done to test the accuracy of the CPR summary parameters TFSCR, TC, TWC, ACR, and NC. Average compression rate detection error was 2.7 compressions per minute (±5.0 cpm), the calculated chest compression rate was within ±10 cpm in 98% (±5.5) of the time, and the average error of the summary CPR parameters was 4.5% (±3.6). The results show that real-time chest compression quality measurement by smartphone camera in simulated cardiac arrest is feasible under the conditions tested.
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Muse ED, Godino JG, Netting JF, Alexander JF, Moran HJ, Topol EJ. From second to hundredth opinion in medicine: A global consultation platform for physicians. NPJ Digit Med 2018; 1:55. [PMID: 31304334 PMCID: PMC6550165 DOI: 10.1038/s41746-018-0064-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Revised: 09/17/2018] [Accepted: 09/19/2018] [Indexed: 11/19/2022] Open
Abstract
Serious medical diagnostic errors lead to adverse patient outcomes and increased healthcare costs. The use of virtual online consultation platforms may lead to better-informed physicians and reduce the incidence of diagnostic errors. Our aim was to assess the usage characteristics of an online, physician-to-physician, no-cost, medical consultation platform, Medscape Consult, from November 2015 through October 2017. Physicians creating original content were noted as “presenters” and those following up as “responders”. During the study period, 37,706 physician users generated a combined 117,346 presentations and responses. The physicians had an average age of 56 years and were from 171 countries on every continent. Over 90% of all presentations received responses with the median time to first response of 1.5 h. Overall, computer- and device-based medical consultation has the capacity to rapidly reach a global medical community and may play a role in the reduction of diagnostic errors.
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Affiliation(s)
- Evan D Muse
- 1Scripps Research Translational Institute, The Scripps Research Institute, La Jolla, CA USA.,2Division of Cardiovascular Disease, Scripps Clinic-Scripps Health, La Jolla, CA USA
| | - Job G Godino
- 1Scripps Research Translational Institute, The Scripps Research Institute, La Jolla, CA USA.,3University of California San Diego, La Jolla, CA USA
| | | | | | | | - Eric J Topol
- 1Scripps Research Translational Institute, The Scripps Research Institute, La Jolla, CA USA.,2Division of Cardiovascular Disease, Scripps Clinic-Scripps Health, La Jolla, CA USA
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