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Jang J, Colletti AA, Ricklefs C, Snyder HJ, Kardonsky K, Duggan EW, Umpierrez GE, O'Reilly-Shah VN. Implementation of App-Based Diabetes Medication Management: Outpatient and Perioperative Clinical Decision Support. Curr Diab Rep 2021; 21:50. [PMID: 34902056 PMCID: PMC8713442 DOI: 10.1007/s11892-021-01421-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/13/2021] [Indexed: 12/15/2022]
Abstract
PURPOSE OF REVIEW Outpatient and perioperative therapeutic decision making for patients with diabetes involves increasingly complex medical-decision making due to rapid advances in knowledge and treatment modalities. We sought to review mobile decision support tools available to clinicians for this essential and increasingly difficult task, and to highlight the development and implementation of novel mobile applications for these purposes. RECENT FINDINGS We found 211 mobile applications related to diabetes from the search, but only five were found to provide clinical decision support for outpatient diabetes management and none for perioperative decision support. We found a dearth of tools for clinicians to navigate these tasks. We highlight key aspects for effective development of future diabetes decision support. These include just-in-time availability, respect for the five rights of clinical decision support, and integration with clinical workflows including the electronic medical record.
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Affiliation(s)
- Jeehoon Jang
- Department of Clinical Informatics, University of Washington School of Medicine, Seattle, WA, USA
| | - Ashley A Colletti
- Department of Anesthesiology & Pain Medicine, University of Washington School of Medicine, RR450, 1959 NE Pacific St, Seattle, WA, 98195, USA
| | - Colbey Ricklefs
- Department of Family Medicine, University of Washington School of Medicine, Seattle, WA, USA
| | - Holly J Snyder
- Department of Anesthesiology & Pain Medicine, University of Washington School of Medicine, RR450, 1959 NE Pacific St, Seattle, WA, 98195, USA
| | - Kimberly Kardonsky
- Department of Family Medicine, University of Washington School of Medicine, Seattle, WA, USA
| | - Elizabeth W Duggan
- Department of Anesthesiology and Perioperative Medicine, University of Alabama Birmingham School of Medicine, Birmingham, AL, USA
| | - Guillermo E Umpierrez
- Division of Endocrinology, Metabolism, and Lipids, Emory University School of Medicine, Atlanta, GA, USA
| | - Vikas N O'Reilly-Shah
- Department of Anesthesiology & Pain Medicine, University of Washington School of Medicine, RR450, 1959 NE Pacific St, Seattle, WA, 98195, USA.
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Moll V, Mariano ER, Kitzman JM, O'Reilly-Shah VN, Jabaley CS. Regional anesthesia educational material utilization varies by World Bank income category: A mobile health application data study. PLoS One 2021; 16:e0244860. [PMID: 33524031 PMCID: PMC7850494 DOI: 10.1371/journal.pone.0244860] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Accepted: 12/17/2020] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION Regional anesthesia offers an alternative to general anesthesia and may be advantageous in low resource environments. There is a paucity of data regarding the practice of regional anesthesia in low- and middle-income countries. Using access data from a free Android app with curated regional anesthesia learning modules, we aimed to estimate global interest in regional anesthesia and potential applications to clinical practice stratified by World Bank income level. METHODS We retrospectively analyzed data collected from the free Android app "Anesthesiologist" from December 2015 to April 2020. The app performs basic anesthetic calculations and provides links to videos on performing 12 different nerve blocks. Users of the app were classified on the basis of whether or not they had accessed the links. Nerve blocks were also classified according to major use (surgical block, postoperative pain adjunct, rescue block). RESULTS Practitioners in low- and middle-income countries accessed the app more frequently than in high-income countries as measured by clicks. Users from low- and middle-income countries focused mainly on surgical blocks: ankle, axillary, infraclavicular, interscalene, and supraclavicular blocks. In high-income countries, more users viewed postoperative pain blocks: adductor canal, popliteal, femoral, and transverse abdominis plane blocks. Utilization of the app was constant over time with a general decline with the start of the COVID-19 pandemic. CONCLUSION The use of an in app survey and analytics can help identify gaps and opportunities for regional anesthesia techniques and practices. This is especially impactful in limited-resource areas, such as lower-income environments and can lead to targeted educational initiatives.
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Affiliation(s)
- Vanessa Moll
- Department of Anesthesiology, Emory University School of Medicine, Atlanta, Georgia, United States of America
- Institute of Anesthesiology, University Hospital Zurich, Zurich, Switzerland
| | - Edward R. Mariano
- Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, California, United States of America
- Anesthesiology and Perioperative Care Service, Veterans Affairs Palo Alto Health Care System, Palo Alto, California, United States of America
| | - Jamie M. Kitzman
- Department of Pediatric Anesthesiology, Children’s Healthcare of Atlanta, Emory University School of Medicine, Atlanta, Georgia, United States of America
| | - Vikas N. O'Reilly-Shah
- Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, Washington, United States of America
| | - Craig S. Jabaley
- Department of Anesthesiology, Emory University School of Medicine, Atlanta, Georgia, United States of America
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O'Reilly-Shah VN, Van Cleve W, Long DR, Moll V, Evans FM, Sunshine JE, Kassebaum NJ, Harrison EM, Jabaley CS. Impact of COVID-19 response on global surgical volumes: an ongoing observational study. Bull World Health Organ 2020; 98:671-682. [PMID: 33177757 PMCID: PMC7652560 DOI: 10.2471/blt.20.264044] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 08/06/2020] [Accepted: 08/07/2020] [Indexed: 11/27/2022] Open
Abstract
Objective To determine whether location-linked anaesthesiology calculator mobile application (app) data can serve as a qualitative proxy for global surgical case volumes and therefore monitor the impact of the coronavirus disease 2019 (COVID-19) pandemic. Methods We collected data provided by users of the mobile app “Anesthesiologist” during 1 October 2018–30 June 2020. We analysed these using RStudio and generated 7-day moving-average app use plots. We calculated country-level reductions in app use as a percentage of baseline. We obtained data on COVID-19 case counts from the European Centre for Disease Prevention and Control. We plotted changing app use and COVID-19 case counts for several countries and regions. Findings A total of 100 099 app users within 214 countries and territories provided data. We observed that app use was reduced during holidays, weekends and at night, correlating with expected fluctuations in surgical volume. We observed that the onset of the pandemic prompted substantial reductions in app use. We noted strong cross-correlation between COVID-19 case count and reductions in app use in low- and middle-income countries, but not in high-income countries. Of the 112 countries and territories with non-zero app use during baseline and during the pandemic, we calculated a median reduction in app use to 73.6% of baseline. Conclusion App data provide a proxy for surgical case volumes, and can therefore be used as a real-time monitor of the impact of COVID-19 on surgical capacity. We have created a dashboard for ongoing visualization of these data, allowing policy-makers to direct resources to areas of greatest need.
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Affiliation(s)
- Vikas N O'Reilly-Shah
- Department of Anesthesiology & Pain Medicine, University of Washington School of Medicine, RR450, 1959 NE Pacific St, Seattle, Washington 98195, United States of America (USA)
| | - Wil Van Cleve
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, USA
| | - Dustin R Long
- Department of Anesthesiology & Pain Medicine, University of Washington School of Medicine, RR450, 1959 NE Pacific St, Seattle, Washington 98195, United States of America (USA)
| | - Vanessa Moll
- Institute of Anesthesiology, University Hospital Zurich, Zurich, Switzerland
| | - Faye M Evans
- Department of Anesthesiology, Critical Care and Pain Medicine, Harvard Medical School, Boston, USA
| | - Jacob E Sunshine
- Department of Anesthesiology & Pain Medicine, University of Washington School of Medicine, RR450, 1959 NE Pacific St, Seattle, Washington 98195, United States of America (USA)
| | - Nicholas J Kassebaum
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, USA
| | - Ewen M Harrison
- Usher Institute, University of Edinburgh, Edinburgh, Scotland, United Kingdom
| | - Craig S Jabaley
- Department of Anesthesiology, Emory University School of Medicine, Atlanta, USA
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O’Reilly-Shah VN, Van Cleve W, Long DR, Moll V, Evans FM, Sunshine JE, Kassebaum NJ, Harrison EM, Jabaley CS. Real-time assessment of COVID-19 impact on global surgical case volumes. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2020:2020.05.03.20086819. [PMID: 32511532 PMCID: PMC7273300 DOI: 10.1101/2020.05.03.20086819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Importance The COVID-19 pandemic has disrupted global surgical capacity. The impact of the pandemic in low and middle income countries has the potential to worsen already strained access to surgical care. Timely assessment of surgical volumes in these countries remains challenging. Objective To determine whether usage data from a globally used anesthesiology calculator mobile application can serve as a proxy for global surgical case volume and contribute to monitoring of the impact of the COVID-19 pandemic, particularly in World Bank low income countries where official data collection is not currently practical. Design Subset of data from an ongoing observational cohort study of users of the application collected from October 1, 2018 to April 18, 2020. Setting The mobile application is available from public sources; users download and use the application per their own clinical needs on personal mobile devices. Participants No user data was excluded from the study. Exposures Events with impacts on surgical case volumes, including weekends, holidays, and the COVID-19 pandemic. Main Outcomes and Measures It was previously noted that application usage was decreased on weekends and during winter holidays. We subsequently hypothesized that more detailed analysis would reveal impacts of country-specific or region-specific holidays on the volume of app use. Results 4,300,975 data points from 92,878 unique users were analyzed. Physicians and other anesthesia providers comprised 85.8% of the study population. Application use was reduced on holidays and weekends and correlated with fluctuations in surgical volume. The COVID-19 pandemic was associated with substantial reductions in app use globally and regionally. There was strong cross correlation between COVID-19 case count and reductions in app use. By country, there was a median global reduction in app use to 58% of baseline (interquartile range, 46%-75%). Application use in low-income continues to decline but in high-income countries has stabilized. Conclusions and Relevance Application usage metadata provides a real-time indicator of surgical volume. This data may be used to identify impacted regions where disruptions to surgical care are disproportionate or prolonged. A dashboard for continuous visualization of these data has been deployed.
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Affiliation(s)
- Vikas N. O’Reilly-Shah
- Department of Anesthesiology & Pain Medicine, University of Washington School of Medicine, 1959 NE Pacific Street, Seattle, WA 98195
| | - Wil Van Cleve
- Department of Anesthesiology & Pain Medicine, University of Washington School of Medicine, 1959 NE Pacific Street, Seattle, WA 98195
| | - Dustin R. Long
- Department of Anesthesiology & Pain Medicine, University of Washington School of Medicine, 1959 NE Pacific Street, Seattle, WA 98195
| | - Vanessa Moll
- Institute of Anesthesiology, University Hospital Zurich, Raemistrasse 100, 8032 Zurich, Switzerland, +41 78 9322617
| | - Faye M. Evans
- Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children’s Hospital, Harvard Medical School, Boston MA, USA
| | - Jacob E. Sunshine
- Department of Anesthesiology & Pain Medicine, University of Washington School of Medicine, 1959 NE Pacific Street, Seattle, WA 98195
| | - Nicholas J. Kassebaum
- Department of Anesthesiology & Pain Medicine, University of Washington School of Medicine, 1959 NE Pacific Street, Seattle, WA 98195
- Dept of Health Metrics Sciences, University of Washington, Seattle, WA, USA
- Dept of Global Health, University of Washington, Seattle, WA, USA
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Ewen M Harrison
- Centre for Medical Informatics, Usher Institute, University of Edinburgh Secretary: 0131 242 3614 (Susan Keggie, Administrative Assistant) and 0131 242 3616 (Murray Britton, Administrative Secretary)
| | - Craig S. Jabaley
- Department of Anesthesiology, Emory University School of Medicine, 1364 Clifton Road, NE, Atlanta, GA, 30322, 404-778-7777
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Formal representation of ambulatory assessment protocols in HTML5 for human readability and computer execution. Behav Res Methods 2018; 51:2761-2776. [PMID: 30406506 PMCID: PMC6877491 DOI: 10.3758/s13428-018-1148-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] [Indexed: 11/08/2022]
Abstract
Ambulatory assessment (AA) is a research method that aims to collect longitudinal biopsychosocial data in groups of individuals. AA studies are commonly conducted via mobile devices such as smartphones. Researchers tend to communicate their AA protocols to the community in natural language by describing step-by-step procedures operating on a set of materials. However, natural language requires effort to transcribe onto and from the software systems used for data collection, and may be ambiguous, thereby making it harder to reproduce a study. Though AA protocols may also be written as code in a programming language, most programming languages are not easily read by most researchers. Thus, the quality of scientific discourse on AA stands to gain from protocol descriptions that are easy to read, yet remain formal and readily executable by computers. This paper makes the case for using the HyperText Markup Language (HTML) to achieve this. While HTML can suitably describe AA materials, it cannot describe AA procedures. To resolve this, and taking away lessons from previous efforts with protocol implementations in a system called TEMPEST, we offer a set of custom HTML5 elements that help treat HTML documents as executable programs that can both render AA materials, and effect AA procedures on computational platforms.
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Monroe KS, Evans MA, Mukkamala SG, Williamson JL, Jabaley CS, Mariano ER, O'Reilly-Shah VN. Moving anesthesiology educational resources to the point of care: experience with a pediatric anesthesia mobile app. Korean J Anesthesiol 2018; 71:192-200. [PMID: 29739184 PMCID: PMC5995022 DOI: 10.4097/kja.d.18.00014] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2018] [Revised: 02/08/2018] [Accepted: 02/19/2018] [Indexed: 11/22/2022] Open
Abstract
Background Educators in all disciplines recognize the need to update tools for the modern learner. Mobile applications (apps) may be useful, but real-time data is needed to demonstrate the patterns of utilization and engagement amongst learners. Methods We examined the use of an anesthesia app by two groups of learners (residents and anesthesiologist assistant students [AAs]) during a pediatric anesthesiology rotation. The app calculates age and weight-based information for clinical decision support and contains didactic materials for self-directed learning. The app transmitted detailed usage information to our research team. Results Over a 12-month period, 39 participants consented; 30 completed primary study procedures (18 residents, 12 AAs). AAs used the app more frequently than residents (P = 0.025) but spent less time in the app (P < 0.001). The median duration of app usage was 2.3 minutes. During the course of the rotation, usage of the app decreased over time. ‘Succinylcholine’ was the most accessed drug, while ‘orientation’ was the most accessed teaching module. Ten (33%) believed that the use of apps was perceived to be distracting by operating room staff and surgeons. Conclusions Real-time in-app analytics helped elucidate the actual usage of this educational resource and will guide future decisions regarding development and educational content. Further research is required to determine learners’ preferred choice of device, user experience, and content in the full range of clinical and nonclinical purposes.
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Affiliation(s)
- Katherine S Monroe
- Department of Anesthesiology, Emory University School of Medicine, Atlanta, USA.,Division of Pediatric Anesthesiology, Children's Healthcare of Atlanta, Atlanta, GA, USA
| | - Michael A Evans
- Department of Anesthesiology, Emory University School of Medicine, Atlanta, USA.,Division of Pediatric Anesthesiology, Children's Healthcare of Atlanta, Atlanta, GA, USA
| | - Shivani G Mukkamala
- Department of Anesthesiology, Emory University School of Medicine, Atlanta, USA.,Division of Pediatric Anesthesiology, Children's Healthcare of Atlanta, Atlanta, GA, USA
| | - Julie L Williamson
- Department of Anesthesiology, Emory University School of Medicine, Atlanta, USA.,Division of Pediatric Anesthesiology, Children's Healthcare of Atlanta, Atlanta, GA, USA
| | - Craig S Jabaley
- Department of Anesthesiology, Emory University School of Medicine, Atlanta, USA
| | - Edward R Mariano
- Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, USA.,Anesthesiology and Perioperative Care Service, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA
| | - Vikas N O'Reilly-Shah
- Department of Anesthesiology, Emory University School of Medicine, Atlanta, USA.,Division of Pediatric Anesthesiology, Children's Healthcare of Atlanta, Atlanta, GA, USA
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Jabaley CS, Wolf FA, Lynde GC, O'Reilly-Shah VN. Crowdsourcing sugammadex adverse event rates using an in-app survey: feasibility assessment from an observational study. Ther Adv Drug Saf 2018; 9:331-342. [PMID: 30034775 DOI: 10.1177/2042098618769565] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Accepted: 03/19/2018] [Indexed: 01/09/2023] Open
Abstract
Background Mobile applications (apps) have become a ubiquitous source of clinical decision support. We sought to ascertain the feasibility of using an app platform to obtain a crowdsourced measure of adverse drug reaction reporting rates associated with sugammadex administration and compare it with traditionally-derived estimates. Methods Using the widely-distributed anesthesia calculator app, 'Anesthesiologist', we surveyed anesthesia providers regarding their experience with adverse drug reactions associated with sugammadex administration. Results Data were analyzed from 2770 participants in 119 countries responding between March 2016 and May 2017, who were estimated to have administered between 1.6-2.9 million doses (588-1040 administrations per participant). A low and high-end reporting rate of adverse events was estimated based on respondents' reported frequency and duration of sugammadex use. The estimated reporting rate of anaphylaxis due to sugammadex was 0.0055-0.098%, similar in range to previously published estimates. Conclusions Use of an in-app survey facilitated a global assessment of anesthesia providers and could have useful applications in monitoring adverse events and estimating their rates. Further work is needed to validate this approach for other medications and clinical domains.
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Affiliation(s)
- Craig S Jabaley
- Department of Anesthesiology, Emory University School of Medicine, Atlanta, GA, USA
| | - Francis A Wolf
- Department of Anesthesiology, Emory University School of Medicine, Atlanta, GA, USA
| | - Grant C Lynde
- Department of Anesthesiology, Emory University School of Medicine, Atlanta, GA, USA
| | - Vikas N O'Reilly-Shah
- Emory University and Children's Healthcare of Atlanta, 3B South, 1364 Clifton Road NE, Atlanta, GA 30322, USA
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O'Reilly-Shah VN, Kitzman J, Jabaley CS, Lynde GC. Evidence for increased use of the Society of Pediatric Anesthesia Critical Events Checklist in resource-limited environments: A retrospective observational study of app data. Paediatr Anaesth 2018; 28:167-173. [PMID: 29285834 DOI: 10.1111/pan.13305] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/26/2017] [Indexed: 11/29/2022]
Abstract
BACKGROUND Electronic decision support tools in anesthesiology practice have great value, including the potential for mobile applications to simplify delivery of best-practice guidelines. AIMS We sought to combine demographics with usage information to elucidate important patterns in the rate of use of the Society of Pediatric Anesthesia Critical Events Checklist, as measured by in-app accesses of the checklist via the freely available anesthesia calculator app anesthesiologist. METHODS We performed a retrospective analytic observational case-control study using analytics and survey data collected from the app. Users of the app were classified on the basis of whether or not they had accessed the checklist. This classification was used to perform logistic regression against a number of independent variables, including frequency of app use, country income level, professional role, rating of app importance, length of time in practice, group size, practice model, community served, and primary practice environment. RESULTS Individual app users practicing in low- and middle-income countries have a significantly higher rate of Society for Pediatric Anesthesia Critical Events Checklist utilization as compared with high-income countries. Rural practitioners had higher utilization of the checklist. Practice size did not affect the utilization of the checklist. The checklist was used for both provider learning and for just-in-time patient care. CONCLUSION mHealth apps are invaluable resource in everyday clinical practice. Mobile app analytics and in-app survey data reveal variable penetration and applicability of such technology worldwide. mHealth apps may be particularly impactful in limited-resource areas, such as lower-income environments and rural communities.
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Affiliation(s)
- Vikas N O'Reilly-Shah
- Department of Anesthesiology, Emory University School of Medicine, Atlanta, GA, USA.,Division of Pediatric Anesthesiology, Children's Healthcare of Atlanta, Atlanta, GA, USA
| | - Jamie Kitzman
- Department of Anesthesiology, Emory University School of Medicine, Atlanta, GA, USA.,Division of Pediatric Anesthesiology, Children's Healthcare of Atlanta, Atlanta, GA, USA
| | - Craig S Jabaley
- Department of Anesthesiology, Emory University School of Medicine, Atlanta, GA, USA
| | - Grant C Lynde
- Department of Anesthesiology, Emory University School of Medicine, Atlanta, GA, USA
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O'Reilly-Shah VN. Comment on: "Gálvez et al.: Interactive pediatric emergency checklists to the palm of your hand - How the pedi crisis app traveled around the world". Paediatr Anaesth 2017; 27:1280-1281. [PMID: 29110432 DOI: 10.1111/pan.13263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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O'Reilly-Shah VN. Factors influencing healthcare provider respondent fatigue answering a globally administered in-app survey. PeerJ 2017; 5:e3785. [PMID: 28924502 PMCID: PMC5600176 DOI: 10.7717/peerj.3785] [Citation(s) in RCA: 80] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2017] [Accepted: 08/18/2017] [Indexed: 11/25/2022] Open
Abstract
Background Respondent fatigue, also known as survey fatigue, is a common problem in the collection of survey data. Factors that are known to influence respondent fatigue include survey length, survey topic, question complexity, and open-ended question type. There is a great deal of interest in understanding the drivers of physician survey responsiveness due to the value of information received from these practitioners. With the recent explosion of mobile smartphone technology, it has been possible to obtain survey data from users of mobile applications (apps) on a question-by-question basis. The author obtained basic demographic survey data as well as survey data related to an anesthesiology-specific drug called sugammadex and leveraged nonresponse rates to examine factors that influenced respondent fatigue. Methods Primary data were collected between December 2015 and February 2017. Surveys and in-app analytics were collected from global users of a mobile anesthesia calculator app. Key independent variables were user country, healthcare provider role, rating of importance of the app to personal practice, length of time in practice, and frequency of app use. Key dependent variable was the metric of respondent fatigue. Results Provider role and World Bank country income level were predictive of the rate of respondent fatigue for this in-app survey. Importance of the app to the provider and length of time in practice were moderately associated with fatigue. Frequency of app use was not associated. This study focused on a survey with a topic closely related to the subject area of the app. Respondent fatigue rates will likely change dramatically if the topic does not align closely. Discussion Although apps may serve as powerful platforms for data collection, responses rates to in-app surveys may differ on the basis of important respondent characteristics. Studies should be carefully designed to mitigate fatigue as well as powered with the understanding of the respondent characteristics that may have higher rates of respondent fatigue.
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Affiliation(s)
- Vikas N O'Reilly-Shah
- Department of Anesthesiology, Emory University, Atlanta, GA, United States of America.,Department of Anesthesiology, Children's Healthcare of Atlanta, Atlanta, GA, United States of America
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O'Reilly-Shah V, Easton G, Gillespie S. Assessing the global reach and value of a provider-facing healthcare app using large-scale analytics. BMJ Glob Health 2017; 2:e000299. [PMID: 29082007 PMCID: PMC5656127 DOI: 10.1136/bmjgh-2017-000299] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2017] [Revised: 04/17/2017] [Accepted: 06/13/2017] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND The rapid global adoption of mobile health (mHealth) smartphone apps by healthcare providers presents challenges and opportunities in medicine. Challenges include ensuring the delivery of high-quality, up-to-date and optimised information. Opportunities include the ability to study global practice patterns, access to medical and surgical care and continuing medical education needs. METHODS We studied users of a free anaesthesia calculator app used worldwide. We combined traditional app analytics with in-app surveys to collect user demographics and feedback. RESULTS 31 173 subjects participated. Users were from 206 countries and represented a spectrum of healthcare provider roles. Low-income country users had greater rates of app use (p<0.001) and ascribed greater importance of the app to their practice (p<0.001). Physicians from low-income countries were more likely to adopt the app (p<0.001). The app was used primarily for paediatric patients. The app was used around the clock, peaking during times typical for first start cases. CONCLUSIONS This mHealth app is a valuable decision support tool for global healthcare providers, particularly those in more resource-limited settings and with less training. App adoption and use may provide a mechanism for measuring longitudinal changes in access to surgical care and engaging providers in resource-limited settings. In-app surveys and app analytics provide a window into healthcare provider behaviour at a breadth and level of detail previously impossible to achieve. Given the potentially immense value of crowdsourced information, healthcare providers should be encouraged to participate in these types of studies.
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Affiliation(s)
- Vikas O'Reilly-Shah
- Department of Anesthesiology, Emory University School of Medicine, Atlanta, Georgia, USA.,Department of Pediatric Anesthesiology, Children's Healthcare of Atlanta, Atlanta, GA, USA
| | - George Easton
- Department of Information Systems & Operations Management, Emory University Goizueta Business School, Atlanta, Georgia, USA
| | - Scott Gillespie
- Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia, USA
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O'Reilly-Shah V, Wolf F, Jabaley C, Lynde G. Using a worldwide in-app survey to explore sugammadex usage patterns: a prospective observational study. Br J Anaesth 2017; 119:333-335. [DOI: 10.1093/bja/aex171] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
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Eddens KS, Fagan JM, Collins T. An Interactive, Mobile-Based Tool for Personal Social Network Data Collection and Visualization Among a Geographically Isolated and Socioeconomically Disadvantaged Population: Early-Stage Feasibility Study With Qualitative User Feedback. JMIR Res Protoc 2017; 6:e124. [PMID: 28642217 PMCID: PMC5500782 DOI: 10.2196/resprot.6927] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2016] [Revised: 04/23/2017] [Accepted: 05/29/2017] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Personal social networks have a profound impact on our health, yet collecting personal network data for use in health communication, behavior change, or translation and dissemination interventions has proved challenging. Recent advances in social network data collection software have reduced the burden of network studies on researchers and respondents alike, yet little testing has occurred to discover whether these methods are: (1) acceptable to a variety of target populations, including those who may have limited experience with technology or limited literacy; and (2) practical in the field, specifically in areas that are geographically and technologically disconnected, such as rural Appalachian Kentucky. OBJECTIVE We explored the early-stage feasibility (Acceptability, Demand, Implementation, and Practicality) of using innovative, interactive, tablet-based network data collection and visualization software (OpenEddi) in field collection of personal network data in Appalachian Kentucky. METHODS A total of 168 rural Appalachian women who had previously participated in a study on the use of a self-collected vaginal swab (SCVS) for human papillomavirus testing were recruited by community-based nurse interviewers between September 2013 and August 2014. Participants completed egocentric network surveys via OpenEddi, which captured social and communication network influences on participation in, and recruitment to, the SCVS study. After study completion, we conducted a qualitative group interview with four nurse interviewers and two participants in the network study. Using this qualitative data, and quantitative data from the network study, we applied guidelines from Bowen et al to assess feasibility in four areas of early-stage development of OpenEddi: Acceptability, Demand, Implementation, and Practicality. Basic descriptive network statistics (size, edges, density) were analyzed using RStudio. RESULTS OpenEddi was perceived as fun, novel, and superior to other data collection methods or tools. Respondents enjoyed the social network survey component, and visualizing social networks produced thoughtful responses from participants about leveraging or changing network content and structure for specific health-promoting purposes. Areas for improved literacy and functionality of the tool were identified. However, technical issues led to substantial (50%) data loss, limiting the success of its implementation from a researcher's perspective, and hindering practicality in the field. CONCLUSIONS OpenEddi is a promising data collection tool for use in geographically isolated and socioeconomically disadvantaged populations. Future development will mitigate technical problems, improve usability and literacy, and test new methods of data collection. These changes will support goals for use of this tool in the delivery of network-based health communication and social support interventions to socioeconomically disadvantaged populations.
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Affiliation(s)
- Katherine S Eddens
- Department of Health, Behavior & Society, College of Public Health, University of Kentucky, Lexington, KY, United States
| | - Jesse M Fagan
- Department of Management, Gatton College of Business and Economics, University of Kentucky, Lexington, KY, United States
| | - Tom Collins
- University of Kentucky Rural Cancer Prevention Center, College of Public Health, University of Kentucky, Lexington, KY, United States
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