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Ahmadzadeh B, Patey C, Hurley O, Knight J, Norman P, Farrell A, Czarnuch S, Asghari S. Applications of Artificial Intelligence in Emergency Departments to Improve Wait Times: Protocol for an Integrative Living Review. JMIR Res Protoc 2024; 13:e52612. [PMID: 38607662 PMCID: PMC11053385 DOI: 10.2196/52612] [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: 09/13/2023] [Revised: 02/14/2024] [Accepted: 03/01/2024] [Indexed: 04/13/2024] Open
Abstract
BACKGROUND Long wait times in the emergency department (ED) are a major issue for health care systems all over the world. The application of artificial intelligence (AI) is a novel strategy to reduce ED wait times when compared to the interventions included in previous research endeavors. To date, comprehensive systematic reviews that include studies involving AI applications in the context of EDs have covered a wide range of AI implementation issues. However, the lack of an iterative update strategy limits the use of these reviews. Since the subject of AI development is cutting edge and is continuously changing, reviews in this area must be frequently updated to remain relevant. OBJECTIVE This study aims to provide a summary of the evidence that is currently available regarding how AI can affect ED wait times; discuss the applications of AI in improving wait times; and periodically assess the depth, breadth, and quality of the evidence supporting the application of AI in reducing ED wait times. METHODS We plan to conduct a living systematic review (LSR). Our strategy involves conducting continuous monitoring of evidence, with biannual search updates and annual review updates. Upon completing the initial round of the review, we will refine the search strategy and establish clear schedules for updating the LSR. An interpretive synthesis using Whittemore and Knafl's framework will be performed to compile and summarize the findings. The review will be carried out using an integrated knowledge translation strategy, and knowledge users will be involved at all stages of the review to guarantee applicability, usability, and clarity of purpose. RESULTS The literature search was completed by September 22, 2023, and identified 17,569 articles. The title and abstract screening were completed by December 9, 2023. In total, 70 papers were eligible. The full-text screening is in progress. CONCLUSIONS The review will summarize AI applications that improve ED wait time. The LSR enables researchers to maintain high methodological rigor while enhancing the timeliness, applicability, and value of the review. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/52612.
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Affiliation(s)
- Bahareh Ahmadzadeh
- Centre for Rural Health Studies, Faculty of Medicine, Memorial University of Newfoundland, St. John's, NL, Canada
| | - Christopher Patey
- Eastern Health, Carbonear Institute for Rural Reach and Innovation by the Sea, Carbonear General Hospital, Carbonear, NL, Canada
- Faculty of Medicine, Memorial University of Newfoundland, St. John's, NL, Canada
| | - Oliver Hurley
- Centre for Rural Health Studies, Faculty of Medicine, Memorial University of Newfoundland, St. John's, NL, Canada
| | - John Knight
- Data and Information Services, Digital Health, NL Health Services, St. John's, NL, Canada
- Division of Community Health and Humanities, Faculty of Medicine, Memorial University of Newfoundland, St. John's, NL, Canada
| | - Paul Norman
- Eastern Health, Carbonear Institute for Rural Reach and Innovation by the Sea, Carbonear General Hospital, Carbonear, NL, Canada
| | - Alison Farrell
- Health Sciences Library, Memorial University of Newfoundland, St. John's, NL, Canada
| | - Stephen Czarnuch
- Department of Electrical and Computer Engineering, Faculty of Engineering and Applied Science, Memorial University of Newfoundland, St. John's, NL, Canada
- Discipline of Emergency Medicine, Faculty of Medicine, Memorial University of Newfoundland, St. John's, NL, Canada
| | - Shabnam Asghari
- Centre for Rural Health Studies, Faculty of Medicine, Memorial University of Newfoundland, St. John's, NL, Canada
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Singh S, Kirk O, Jaffar S, Karakezi C, Ramaiya K, Kallestrup P, Kraef C. Patient perspectives on integrated healthcare for HIV, hypertension and type 2 diabetes: a scoping review. BMJ Open 2021; 11:e054629. [PMID: 34785559 PMCID: PMC8596045 DOI: 10.1136/bmjopen-2021-054629] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION Antiretroviral therapy has reduced mortality and led to longer life expectancy in people living with HIV. These patients are now at an increased risk of non-communicable diseases (NCDs). Integration of care for HIV and NCDs has become a focus of research and policy. In this article, we aim to review patient perspectives on integration of healthcare for HIV, type 2 diabetes and hypertension. METHODS The framework for scoping reviews developed by Arksey and O'Malley and updated by Peter et al was applied for this review. The databases PubMed, Web of Science and Cochrane library were searched. Broad search terms for HIV, NCDs (specifically type 2 diabetes and hypertension) and healthcare integration were used. As the review aimed to identify definitions of patient perspectives, they were not included as an independent term in the search strategy. References of included publications were searched for relevant articles. Titles and abstracts for these papers were screened by two independent reviewers. The full texts for all the publications appearing to meet the inclusion criteria were then read to make the final literature selection. RESULTS Of 5502 studies initially identified, 13 articles were included in this review, of which 11 had a geographical origin in sub-Saharan Africa. Nine articles were primarily focused on HIV/diabetes healthcare integration while four articles were focused on HIV/hypertension integration. Patient's experiences with integrated care were reduced HIV-related stigma, reduced travel and treatment costs and a more holistic person-centred care. Prominent concerns were long waiting times at clinics and a lack of continuity of care in some clinics due to a lack of healthcare workers. Non-integrated care was perceived as time-consuming and more expensive. CONCLUSION Patient perspectives and experiences on integrated care for HIV, diabetes and hypertension were mostly positive. Integrated services can save resources and allow for a more personalised approach to healthcare. There is a paucity of evidence and further longitudinal and interventional evidence from a more diverse range of healthcare systems are needed.
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Affiliation(s)
- Sabine Singh
- Department of Public Health, Aarhus University, Aarhus, Denmark
- Danish Non-communicable Diseases Alliance, Copenhagen, Denmark
| | - Ole Kirk
- Department of Infectious Disease, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Shabbar Jaffar
- Department of International Public Health, Liverpool School of Tropical Medicine, Liverpool, UK
| | | | - Kaushik Ramaiya
- Shree Hindu Mandal Hospital, Dar es Salaam, Tanzania, United Republic of
| | - P Kallestrup
- Danish Non-communicable Diseases Alliance, Copenhagen, Denmark
- Centre for Global Health, Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Christian Kraef
- Danish Non-communicable Diseases Alliance, Copenhagen, Denmark
- Department of Infectious Disease, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
- Centre of Excellence for Health, Immunity and Infections (CHIP), Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
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Asghari S, Hurd J, Marshall Z, Maybank A, Hesselbarth L, Hurley O, Farrell A, Kendall CE, Rourke SB, Becker M, Johnston S, Lundrigan P, Rosenes R, Bibeau C, Liddy C. Challenges with access to healthcare from the perspective of patients living with HIV: a scoping review & framework synthesis. AIDS Care 2018; 30:963-972. [PMID: 29397762 DOI: 10.1080/09540121.2018.1435848] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Accessing healthcare can be difficult but the barriers multiply for people living with HIV (PLHIV). To improve access and the health of PLHIV, we must consider their perspectives and use them to inform standard practice. A better understanding of the current literature related to healthcare access from the perspective of PLHIV, can help to identify evidence gaps and highlight research priorities and opportunities. To identify relevant peer-reviewed publications, search strategies were employed. Electronic and grey literature databases were explored. Articles were screened based on their title and abstract and those that met the screening criteria, were reviewed in full. Data analysis was conducted using a collaborative approach that included knowledge user consultation. Initial concepts were extracted, summarized and through framework synthesis, developed into emerging and final themes. From 20,678 articles, 326 articles met the initial screening criteria and 64 were reviewed in full. The final themes identified, in order of most to least frequent were: Acceptability, Availability, Accessibility, Affordability, Other Barriers, Communication, Satisfaction, Accommodation, Preferences and Equity in Access. The most frequently discussed concepts related to negative interactions with staff, followed by long wait times, limited household resources or inability to pay fees, and fear of one's serostatus being disclosed. Knowledge users were in agreement with the categorization of initial concepts and final themes; however, some gaps in the literature were identified. Specific changes are critical to improving access to healthcare for PLHIV. These include improving availability by ensuring staff and healthcare professionals have proper training, cultivating acceptability and reducing stigma through improving HIV awareness, increasing accessibility through increased HIV information for PLHIV and improved dissemination of this information to increase patient knowledge and health awareness. Finally, ensuring proper protocols are implemented and followed to guarantee patient confidentiality and overall satisfaction with healthcare services are recommended.
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Affiliation(s)
- Shabnam Asghari
- a Department of Family Medicine , Memorial University of Newfoundland, Health Sciences Centre , St. John's , NL , Canada
| | - Jillian Hurd
- a Department of Family Medicine , Memorial University of Newfoundland, Health Sciences Centre , St. John's , NL , Canada
| | - Zack Marshall
- b School of Social Work , McGill University , Montreal , QC , Canada
| | - Allison Maybank
- a Department of Family Medicine , Memorial University of Newfoundland, Health Sciences Centre , St. John's , NL , Canada
| | - Lydia Hesselbarth
- a Department of Family Medicine , Memorial University of Newfoundland, Health Sciences Centre , St. John's , NL , Canada
| | - Oliver Hurley
- a Department of Family Medicine , Memorial University of Newfoundland, Health Sciences Centre , St. John's , NL , Canada
| | - Alison Farrell
- a Department of Family Medicine , Memorial University of Newfoundland, Health Sciences Centre , St. John's , NL , Canada
| | - Claire E Kendall
- c Bruyere Research Institute , University of Ottawa , Ottawa , ON , Canada
| | - Sean B Rourke
- d Li Ka Shing Knowledge Institute , St. Michael's Hospital , Toronto , ON , Canada
| | - Marissa Becker
- e Centre for Global Public Health , University of Manitoba , Winnipeg , MB , Canada
| | - Sharon Johnston
- c Bruyere Research Institute , University of Ottawa , Ottawa , ON , Canada
| | - Phil Lundrigan
- c Bruyere Research Institute , University of Ottawa , Ottawa , ON , Canada
| | - Ron Rosenes
- c Bruyere Research Institute , University of Ottawa , Ottawa , ON , Canada
| | - Christine Bibeau
- c Bruyere Research Institute , University of Ottawa , Ottawa , ON , Canada
| | - Clare Liddy
- c Bruyere Research Institute , University of Ottawa , Ottawa , ON , Canada
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Alexandra Marshall S, Brewington KM, Kathryn Allison M, Haynes TF, Zaller ND. Measuring HIV-related stigma among healthcare providers: a systematic review. AIDS Care 2017; 29:1337-1345. [PMID: 28599599 DOI: 10.1080/09540121.2017.1338654] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
In the United States, HIV-related stigma in the healthcare setting is known to affect the utilization of prevention and treatment services. Multiple HIV/AIDS stigma scales have been developed to assess the attitudes and behaviors of the general population in the U.S. towards people living with HIV/AIDS, but fewer scales have been developed to assess HIV-related stigma among healthcare providers. This systematic review aimed to identify and evaluate the measurement tools used to assess HIV stigma among healthcare providers in the U.S. The five studies selected quantitatively assessed the perceived HIV stigma among healthcare providers from the patient or provider perspective, included HIV stigma as a primary outcome, and were conducted in the U.S. These five studies used adapted forms of four HIV stigma scales. No standardized measure was identified. Assessment of HIV stigma among providers is valuable to better understand how this phenomenon may impact health outcomes and to inform interventions aiming to improve healthcare delivery and utilization.
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Affiliation(s)
- S Alexandra Marshall
- a Department of Health Behavior & Health Education , Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences , Little Rock , AR , USA
| | | | - M Kathryn Allison
- a Department of Health Behavior & Health Education , Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences , Little Rock , AR , USA
| | - Tiffany F Haynes
- a Department of Health Behavior & Health Education , Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences , Little Rock , AR , USA
| | - Nickolas D Zaller
- a Department of Health Behavior & Health Education , Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences , Little Rock , AR , USA
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