Public health surveillance in the U.S. Department of Veterans Affairs: evaluation of the Praedico surveillance system

The application of artificial intelligence in health policy: a scoping review

BACKGROUND

Policymakers require precise and in-time information to make informed decisions in complex environments such as health systems. Artificial intelligence (AI) is a novel approach that makes collecting and analyzing data in complex systems more accessible. This study highlights recent research on AI's application and capabilities in health policymaking.

METHODS

We searched PubMed, Scopus, and the Web of Science databases to find relevant studies from 2000 to 2023, using the keywords "artificial intelligence" and "policymaking." We used Walt and Gilson's policy triangle framework for charting the data.

RESULTS

The results revealed that using AI in health policy paved the way for novel analyses and innovative solutions for intelligent decision-making and data collection, potentially enhancing policymaking capacities, particularly in the evaluation phase. It can also be employed to create innovative agendas with fewer political constraints and greater rationality, resulting in evidence-based policies. By creating new platforms and toolkits, AI also offers the chance to make judgments based on solid facts. The majority of the proposed AI solutions for health policy aim to improve decision-making rather than replace experts.

CONCLUSION

Numerous approaches exist for AI to influence the health policymaking process. Health systems can benefit from AI's potential to foster the meaningful use of evidence-based policymaking.

Risk of Hospitalization and Mortality Following Medically Attended Norovirus Infection-Veterans Health Administration, 2010-2018

Background

While prior studies have suggested a role for norovirus gastroenteritis in contributing to severe morbidity and mortality, the importance of norovirus as a causal pathogen for hospitalization and mortality remains poorly understood. We estimated the effect of laboratory-confirmed norovirus infection on hospitalization and mortality among a national cohort of veterans who sought care within the Veterans Affairs health care system.

Methods

We analyzed electronic health record data from a cohort study of adults who were tested for norovirus within the Veterans Affairs system between 1 January 2010 and 31 December 2018. Adjusted risk ratios (aRRs) for hospitalization and mortality were estimated using log-binomial regression models, adjusting for age, Clostridioides difficile, underlying medical conditions, and nursing home residence.

Results

In total, 23 196 veterans had 25 668 stool samples tested for norovirus; 2156 samples (8.4%) tested positive. Testing positive for norovirus infection, compared with testing negative, was associated with a slight increased risk of hospitalization (aRR, 1.13 [95% confidence interval, 1.06-1.21]) and a significant increased risk of mortality within 3 days after the norovirus test (2.14 [1.10-4.14]). The mortality aRR within 1 week and 1 month were reduced to 1.40 (95% confidence interval, .84-2.34) and 0.97 (.70-1.35), respectively.

Conclusions

Older veterans with multiple comorbid conditions were at a slight increased risk of hospitalization and significant increased risk of mortality in the 3 days after a norovirus-positive test, compared with those testing negative. Clinicians should be aware of these risks and can use these data to inform clinical management for veterans with norovirus.

An in-depth review of the UNICEF NutriDash platform, lessons learnt and future perspectives: a mixed-methods study

OBJECTIVES

Robust data on nutrition are essential to realise the right to nutrition for every child. Created in 2009, UNICEF's Nutrition Dashboard (NutriDash) collects nutrition programme information from 125 countries. An in-depth review of NutriDash was conducted to understand its strengths and identify key actions to increase its effectiveness and efficiency.

METHODS

Adapting the Centres for Disease Control and Prevention updated guidelines for evaluating public health surveillance systems, a mixed-methods approach was used. A questionnaire was designed to capture information on key attributes of NutriDash and disseminated to UNICEF country offices for quantitative feedback on user experiences. Structured key informant interviews were held with internal and external stakeholders to gain qualitative perceptions on data generated from NutriDash. Analysis involved producing frequency distributions for the questionnaire data and performing thematic analyses on interview data.

RESULTS

A total of 53 respondents completed the questionnaire (42% response rate), representing 48 countries and good regional geographic representation. Most respondents (96%) worked in UNICEF country offices. The percentages of participants who agreed or strongly agreed with each attribute of the NutriDash system were as follows: acceptability: 71%, stability: 68%, simplicity; 63%, data quality: 60%, flexibility: 58% and usefulness: 43%. Internal and external stakeholders commented on the value of NutriDash; its use ranging from nutrition global trend monitoring for programme planning to producing reports and dashboards. Key themes derived from this review as areas for improvement included communication, access to data and data quality.

CONCLUSIONS

This review has identified key themes that will inform improvements to NutriDash and form a baseline for future periodic reviews to continuously enhance the system to improve availability of timely quality nutrition programme data. UNICEF will continue to engage with countries, key partners and governments to improve the NutriDash data value chain and ensure the right to nutrition for every child.