A study to design minimum data set of COVID-19 registry system

Evaluating information management system in epidemic infectious diseases in Iran

Health information management is a vital and constructive component of the health system, refers to the process of producing and collecting, organising and storing, analysing, disseminating and using information. The aim of this study was to evaluate the strengths and weaknesses of the information management system in epidemic infectious diseases in Iran, specifically focusing on the registration, reporting, quality, confidentiality, and security of infectious disease data. This assessment was conducted from the perspective of policymakers and experts responsible for data registration and reporting. After examining the processes of registering and reporting infectious disease data and interviewing experts, a researcher-designed questionnaire was prepared to evaluate the infectious disease information management system. To assess the content validity of the Content Validity Index and Content Validity Ratio Index, a questionnaire was utilized. The reliability of the questionnaire was confirmed using Cronbach's alpha. By employing purposeful sampling and adhering to the inclusion criteria, 150 participants were included in the study. Questionnaires were distributed via email, WhatsApp, or Telegram to employees at various levels of Iran's health and treatment systems who were responsible for registering and reporting infectious disease data. The study encompassed 100 participants who successfully concluded the research. The results highlight that the key strength of healthcare data registration lies in its ability to "depict the epidemic curve during outbreaks of infectious diseases." Conversely, a notable weakness was the "insufficient collaboration from non-academic sectors (e.g., clinics, private laboratories) in registering and reporting infectious diseases. The present study's findings suggest that the issue lies not in the framework itself, but rather in the execution and functionality of the strategies. We can cultivate a repository of reliable and beneficial data by incorporating initiatives like training programs, enforcing regulations with consequences for inadequate data documentation, offering both material and motivational rewards, and streamlining all data collection and reporting systems.

Optimising Clinical Epidemiology in Disease Outbreaks: Analysis of ISARIC-WHO COVID-19 Case Report Form Utilisation

Standardised forms for capturing clinical data promote consistency in data collection and analysis across research sites, enabling faster, higher-quality evidence generation. ISARIC and the World Health Organization have developed case report forms (CRFs) for the clinical characterisation of several infectious disease outbreaks. To improve the design and quality of future forms, we analysed the inclusion and completion rates of the 243 fields on the ISARIC-WHO COVID-19 CRF. Data from 42 diverse collaborations, covering 1886 hospitals and 950,064 patients, were analysed. A mean of 129.6 fields (53%) were included in the adapted CRFs implemented across the sites. Consistent patterns of field inclusion and completion aligned with globally recognised research priorities in outbreaks of novel infectious diseases. Outcome status was the most highly included (95.2%) and completed (89.8%) field, followed by admission demographics (79.1% and 91.6%), comorbidities (77.9% and 79.0%), signs and symptoms (68.9% and 78.4%), and vitals (70.3% and 69.1%). Mean field completion was higher in severe patients (70.2%) than in all patients (61.6%). The results reveal how clinical characterisation CRFs can be streamlined to reduce data collection time, including the modularisation of CRFs, to offer a choice of data volume collection and the separation of critical care interventions. This data-driven approach to designing CRFs enhances the efficiency of data collection to inform patient care and public health response.

Relationship between health literacy and generalized anxiety disorder during the COVID-19 pandemic in Khuzestan province, Iran

Introduction

During the COVID-19 pandemic, many changes occurred in various cultural, social, and economic fields, leading to the creation of psychological effects, especially anxiety, in the community. Fear and anxiety about emerging diseases (COVID-19) and less participation in preventive behaviors reduce individual resistance and ultimately lower one's quality of life. Therefore, we aimed to investigate the relationship between health literacy and generalized anxiety disorder during the COVID-19 pandemic in Khuzestan province, Iran.

Methods

This was a descriptive-analytical (cross-sectional) study conducted among participants aged 18-65 in Khuzestan province during the years 2020-2021 through online sampling. Due to the prevalence of COVID-19 and the impossibility of face-to-face communication, the questionnaire was designed on the Porseline Survey website and the questionnaire link was provided to participants through WhatsApp and Telegram. The data collection tool includes the Iranian Health Literacy Questionnaire, which includes 33 items, and the Generalized Anxiety Disorder-7 scale, which has 7 items based on a Likert scale. Data analysis was performed using STATA14 software and descriptive and analytical statistical tests at a significant level less than 0.05.

Results

The mean (standard deviation) score for health literacy was 52.9 ± 9.3 and for generalized anxiety disorder was 5.2 ± 3.1. A significant negative correlation was found between the mean of anxiety disorder and health literacy (p < 0.05). The frequency of health literacy in individuals included 427 (37.8%) with inadequate health literacy, 628 (55.6%) with marginal health literacy, and 75 (6.6%) with sufficient health literacy. There was a statistically significant difference between the mean of generalized anxiety disorder among individuals with different levels of health literacy (p < 0.05).

Conclusion

As the level of health literacy increases, the prevalence of generalized anxiety disorder caused by fear of COVID-19 decreases. Therefore, increasing awareness and health literacy about this virus, its transmission, and prevention methods is very effective in managing anxiety and stress caused by COVID-19. Paying attention to the issue of health literacy and generalized anxiety disorder, and promoting preventive behaviors can be effective tools for planners, health officials, and policymakers to promote health literacy for any type of disease.

Clinical Characteristics and Outcomes in Hospitalized Patients with COVID-19 and Cancer History: A Multicenter Cross-Sectional Study in Southwestern Iran

Background: Cancer patients are more exposed to opportunistic infections, such as COVID-19, due to their poor health status. This study aimed to identify the clinical characteristics of cancer and non-cancer patients with COVID-19 that may lead to death, intubation, and ICU admission. Materials and Methods: A Multicenter Cross-Sectional study was conducted on confirmed COVID-19 adult patients with and without a history of cancer from March 2019 to March 2021. Demographic and clinical features, ICU admission, intubation, and discharge status have been extracted from patients' medical records. Chi-square, odds ratio, Mann-Whitney test, and logistic regression were used to analyze the data. Results: The death rate in 1332 cancer patients was 28% compared to the 91464 noncancer patients which was 9% with an odds ratio of 3.94 and p<0.001. ICU admission rates among the cancer group were 43%, while in the noncancer group, it was 17.9% (p<0.001). Moreover, intubation was done for 20.9% of cancer patients and 7.4% of non-cancer patients (p<0.001). However, no significant difference was observed between the two groups in terms of length of stay in the hospital. Multivariable logistic regression analysis showed that age, level of consciousness, SPO2, and autoimmune disorders were associated with mortality in cancer patients with COVID-19. Conclusion: This study showed that older age, loss of consciousness, low oxygen saturation, and suffering from autoimmune disorders were the predictors of death in cancer patients with COVID-19. These results can have important implications for the management and care of cancer patients with COVID-19.

Designing a minimum data set for the information management system (registry) of spinal canal stenosis: An applied-descriptive study

Background and Aims

Spinal canal stenosis is one of the most common vertebral column diseases, which can lead to disability. Developing a registry system can help in research on the prevention and effective treatment of it. This study designs a minimum data set (MDS) as the first step in creating a registry system for spinal canal stenosis.

Method

The present research is of applied-descriptive type, performed in 2022. First, the applicable data elements about the disease were selected from a vast range of English and Farsi references, including peer reviewed articles, academic books, credible websites, and medical records of hospitalized patients. Through the extracted data, the primary MDS plan was designed as a questionnaire. The validity of the questionnaire was conducted via asking the opinion of experts (neurosurgeons, physiotherapists, epidemiologists, and health information management specialists). Also, its reliability was calculated via Cronbach ⍺ coefficient, which was 86%. Finally, the MDS of the spinal canal stenosis national registry system (for Iran) was confirmed through a two stage Delphi technique. Data analysis was applied through descriptive statistics via SPSS21 software.

Results

The proposed MDS is offered in two general sets of data: administrative and clinical. For the administrative data set, 40 data elements had been proposed, as five classes. Twenty-six of them were confirmed. In the clinical section, 95 data elements had been proposed in 14 classes; 94 of which were finally confirmed.

Conclusion

Since there is no spinal canal stenosis MDS available, this study can be a turning point in the standardization of the data on this disease. Moreover, these precise, coherent, and standard data elements can be contributed to improving disease management and enhancing the public healthcare quality. Also, the MDS proposed in this study can help researchers and experts, design a spinal canal stenosis registry system in other countries.

Dos and don'ts in designing a computerized oral and lip squamous cell cancer registry

BACKGROUND

In the last ten years, many countries have started to develop constructive systems for registering common diseases and cancers. In this research, we intended to determine and identify the minimum data set (MDS) required for the design of the oral and lip squamous cell cancer registration system in Iran.

METHODS AND MATERIAL

At first, primary information elements related to disease registries were extracted using scientific papers published in reliable databases. After reviewing the books, related main guidelines, and 42 valid articles, the initial draft of a researcher-made questionnaire was compiled. To validate the questionnaire, two focus group meetings were held with 29 expert panel members. The final version of this questionnaire was prepared by extracting different questions and categories and receiving numerous pieces of feedback from specialists. Lastly, a final survey was conducted by the experts who were present at the previous stage.

RESULTS

Out of 29 experts participating in the study, 17 (58.62%) were men and 12 (40.37%) were women. The age range of experts varies from 34 to 58 years. One hundred-fourteen items, which are divided into ten main parts, were considered the main information elements of the registry design. The main minimum data sets have pertained to the demographic and clinical information of the patient, information related to the consumed drugs, initial diagnostic evaluations of the patient, biopsy, tumor staging at the time of diagnosis, clinical characteristics of the tumor, surgery, histopathological characteristics of the tumor, pathologic stage classification, radiotherapy details, follow-up information, and disease registry capabilities. The distinctive characteristics of the oral and lip squamous cell cancer registry systems, such as the title of the disease registration programme, the population being studied, the geographic extent of the registration, its primary goals, the definition of the condition, the technique of diagnosis, and the kind of registration, are all included in a model.

CONCLUSION

The benefits of designing and implementing disease registries can include timely access to medical records, registration of information related to patient care and follow-up of patients, the existence of standard forms and the existence of standard information elements, and the existence of an integrated information system at the country level.

[Corticoid treatment and SARS-CoV-2 variants: two independent factors associated with COVID-19 mortality in a Spanish regional hospital]

BACKGROUND

Pandemic inter-wave hospital admissions and COVID-19-related mortality rates vary greatly. Some of the factors that may be playing part in this are the profile of the patients, viral variants, pharmacological treatments, or preventive measures. This work aimed to analyze the factors associated with mortality in COVID-19 patients admitted to hospital during 2020-2021.

METHODS

Retrospective cohort study with COVID-19 patients admitted to Hospital de Barbastro (Spain) during 2020-2021. Data were collected from the Spanish Conjunto Mínimo Básico de Datos and microbiology and electronic prescription records.

RESULTS

During the study period, 908 patients were consecutively admitted for COVID-19 (median age 70 years, 57.2% males); 162 (17.8%) patients died. We identified seven successive epidemiological waves. The following variables significantly associated to higher mortality: age, arterial hypertension, chronic renal failure, dementia, chronic obstructive pulmonary disease, heart failure, prior stroke, Charlson index, and wave 2; wave 4 was associated to greater survival. The multivariate analysis showed that age (OR=1.11; 95% CI: 1.09-1.14), chronic obstructive pulmonary disease (OR=2.33; 95% CI: 1.18-4.57), wave 2 (OR=2.57; 95% CI: 1.10-6.00), and wave 3 (OR=2.94; 95% CI: 1.17-7.38) associated with higher mortality. Glucocorticoid treatment was the only protective factor (OR=0.29; 95%CI: 0.14-0.62).

CONCLUSIONS

This study confirms the therapeutic utility of glucocorticoids to reduce in-hospital mortality due to COVID-19. Heterogeneous mortality rates between the different COVID-19 waves suggest a direct role of viral variants as determinants of lethality, regardless of the patient's history.

Relationship Between Mental Health and Death Anxiety During COVID-19 Pandemic in Dental Staff and Students: A Cross-Sectional Study

OBJECTIVE

We aimed to determine the mental health and death anxiety among dental staff and students in school of dentistry during COVID-19 pandemic.

METHODS

It was a cross-sectional study among students (n = 300) and staff (n = 60) in School of dentistry in Ahvaz University of Medical Sciences during 2020. The instruments were a demographic questionnaire, Death Anxiety Scale, and Kessler Questionnaire. Data was analyze by using SPSS version 22, in all tests, the significance level was set at <0.05.

RESULTS

The mean age of dental students and personnel was 23.96 and 40.08 years, respectively. The mean scores of death anxiety were higher in dental staff (8.53) than students (6.02) and the mean scores of mental health status were higher in students (14.78) than personnel (9.18). This indicates that death anxiety was higher in Dental staff, while students were in better mental health status. The correlation coefficient between death anxiety and mental health status was 0.366 among students (p < 0.001), while it was 0.429 among dental staff (p < 0.001), showing a medium relationship between death anxiety and mental health in both groups.

CONCLUSION

The overall findings represent a significant but contradictory relationship between mental health status and death anxiety among dental staff and students during the prevalence of COVID-19 pandemic. This suggests the impact of confounding factors in this area, which can be studied by future researchers and policy makers to design health promotion interventions.