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Journal of Innovation in Health... Dec 2018Due to the many advantages of open source software (OSS), including reduced cost of licensing, more flexibility in terms of customisation and redistribution, better...
INTRODUCTION
Due to the many advantages of open source software (OSS), including reduced cost of licensing, more flexibility in terms of customisation and redistribution, better quality and no vendor lock-in, OSS in healthcare is increasingly gaining importance. Various open source health information technologies (OS-HITs) are continuously being designed and developed for different areas of healthcare to increase organisational efficiencies and quality of care at minimum costs. The objective of this scoping review is to identify the kinds of existing OS-HITs, their characteristics (e.g. functions) and capabilities (e.g. advantages/disadvantages) for various healthcare stakeholders (physicians and patients) and healthcare sectors (e.g. clinical, administrative).
METHODS
We will conduct a scoping review to identify the range of available OS-HITs in international literature from 1980 to September 2018. Searches will be conducted in six major international databases, namely: Cumulative Index to Nursing and Allied Health Literature Plus, Excerpta Medica Database, Global Health, Library Information Science and Technology Abstracts, Medline and Web of Science to identify relevant published research. We will also search the Google search engine and Google Scholar for on-going and unpublished work and the grey literature. Searches will be peer-reviewed by two independent reviewers and will not be limited by methodology or language. Next, selected references will be tabulated for study characteristics by author affiliation, country of origin, the name of OS-HIT, healthcare area/sector, system requirements, stakeholders, complete solution and web link. Furthermore, functions, benefits/advantages, disadvantages and outcomes (e.g. usability) of OS-HITs will be extracted. Narrative and interpretative synthesis of data will be undertaken.
RESULTS
We will report our findings in a peer-reviewed journal.
Topics: Delivery of Health Care; Humans; Internationality; Medical Informatics; Software
PubMed: 30672406
DOI: 10.14236/jhi.v25i4.1022 -
European Journal of Clinical... Nov 2019Poorly described placebo/sham controls make it difficult to appraise active intervention benefits and harms. The 12-item Template for Intervention Description and...
BACKGROUND
Poorly described placebo/sham controls make it difficult to appraise active intervention benefits and harms. The 12-item Template for Intervention Description and Replication (TIDieR) checklist was developed to improve the reporting of active interventions. The extent to which TIDieR has been used to improve description of placebo or sham control is not known.
MATERIALS AND METHODS
We systematically identified and examined all placebo/sham-controlled randomised trials published in 2018 in the top six general medical journals. We reported how many of the TIDieR checklist items were used to describe the placebo/sham control(s). We supplemented this with a sample of 100 placebo/sham-controlled trials from any journal and searched Google Scholar to identify placebo/sham-controlled trials citing TIDieR.
RESULTS
We identified 94 placebo/sham-controlled trials published in the top journals in 2018. None reported using TIDieR, and none reported placebo or sham components completely. On average eight TIDieR items were addressed, with placebo/sham control name (100%) and when and how much was administered (97.9%) most commonly reported. Some items (rationale, 8.5%, whether there were modifications, 25.5%) were less often reported. In our sample of less well-cited journals, reporting was poorer (average of six items) and followed a similar pattern. Since TIDieR's first publication, six placebo-controlled trials have cited it according to Google Scholar. Two of these used the checklist to describe placebo controls; neither one completely desribed the placebo intervention.
CONCLUSIONS
Placebo and sham controls are poorly described within randomised trials, and TIDieR is rarely used to guide these descriptions. We recommend developing guidelines to promote better descriptions of placebo/sham control components within clinical trials.
Topics: Checklist; Control Groups; Humans; Placebos; Randomized Controlled Trials as Topic; Research Report
PubMed: 31519047
DOI: 10.1111/eci.13169 -
Administration and Policy in Mental... Jan 2020Inadequate implementation strategy reporting restricts research synthesis and replicability. We explored the implementation strategy reporting quality of a sample of...
Inadequate implementation strategy reporting restricts research synthesis and replicability. We explored the implementation strategy reporting quality of a sample of mental health articles using Proctor et al.'s (Implement Sci 8:139, 2013) reporting recommendations. We conducted a narrative review to generate the sample of articles and assigned a reporting quality score to each article. The mean article reporting score was 54% (range 17-100%). The most reported domains were: name (100%), action (82%), target (80%), and actor (67%). The least reported domains included definition (6%), temporality (26%), justification (34%), and outcome (37%). We discuss limitations and provide recommendations to improve reporting.
Topics: Evidence-Based Practice; Health Plan Implementation; Humans; Implementation Science; Mental Health; Research
PubMed: 31482489
DOI: 10.1007/s10488-019-00965-8 -
Heliyon Dec 2022The advancement of information and communication technologies has led to an increasing use of conversational chatbots in the learning and teaching sector, especially for...
The advancement of information and communication technologies has led to an increasing use of conversational chatbots in the learning and teaching sector, especially for the second language (L2) acquisition. In the field of second language acquisition, the use of AI chatbots has been explored, mainly studying pedagogical approaches. However, there is a limited study in the development of empathetic strategies for dealing with learners' emotional discomfort, the impact of humor and the consideration of learners' cultural backgrounds. Thus, this study reviews the existing studies on AI second language (L2) chatbots to investigate the development of empathetic strategies for enhancing learners' learning outcomes. To achieve the aim of this study, prior studies from 2012 and 2022 of several popular databases, including Web of Science, ProQuest, IEEE and ScienceDirect are collected and analyzed. This study found that three dimensions such as cultural, empathetic and humorous dimensions have a positive influence on the application of AI L2 chatbots for enhancing learners' learning outcomes. This study also found that the development of an AI chatbot in L2 education has plenty of room for improvement. Several recommendations are made for enhancing the use of AI L2 chatbots which include integrating cross-cultural empathetic responses in conversational L2 chatbots, identifying how learners perceive and react to the learning content, and investigating the effects of cross-culture humor on learners' language proficiency.
PubMed: 36531630
DOI: 10.1016/j.heliyon.2022.e12056 -
CNS Drugs Aug 2020Refractory status epilepticus (RSE) represents a serious medical condition requiring early and targeted therapy. Given the increasing number of elderly or multimorbid... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Refractory status epilepticus (RSE) represents a serious medical condition requiring early and targeted therapy. Given the increasing number of elderly or multimorbid patients with a limitation of life-sustaining therapy (LOT) or within a palliative care setting (PCS), guidelines-oriented therapy escalation options for RSE have to be omitted frequently.
OBJECTIVES
This systematic review sought to summarize the evidence for fourth-line antiseizure drugs (ASDs) and other minimally or non-invasive therapeutic options beyond guideline recommendations in patients with RSE to elaborate on possible treatment options for patients undergoing LOT or in a PCS.
METHODS
A systematic review of the literature in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, focusing on fourth-line ASDs or other minimally or non-invasive therapeutic options was performed in February and June 2020 using the MEDLINE, EMBASE and Cochrane databases. The search terminology was constructed using the name of the specific ASD or therapy option and the term 'status epilepticus' with the use of Boolean operators, e.g. "(brivaracetam) AND (status epilepticus)". The respective Medical Subject Headings (MeSH) and Emtree terms were used, if available.
RESULTS
There is currently no level 1, grade A evidence for the use of ASDs in RSE. The best evidence was found for the use of lacosamide and topiramate (level 3, grade C), followed by brivaracetam, perampanel (each level 4, grade D) and stiripentol, oxcarbazepine and zonisamide (each level 5, grade D). Regarding non-medicinal options, there is little evidence for the use of the ketogenic diet (level 4, grade D) and magnesium sulfate (level 5, grade D) in RSE. The broad use of immunomodulatory or immunosuppressive treatment options in the absence of a presumed autoimmune etiology cannot be recommended; however, if an autoimmune etiology is assumed, steroid pulse, intravenous immunoglobulins and plasma exchange/plasmapheresis should be considered (level 4, grade D). Even if several studies suggested that the use of neurosteroids (level 5, grade D) is beneficial in RSE, the current data situation indicates that there is formal evidence against it.
CONCLUSIONS
RSE in patients undergoing LOT or in a PCS represents a challenge for modern clinicians and epileptologists. The evidence for the use of ASDs in RSE beyond that in current guidelines is low, but several effective and well-tolerated options are available that should be considered in this patient population. More so than in any other population, advance care planning, advance directives, and medical ethical aspects have to be considered carefully before and during therapy.
Topics: Anticonvulsants; Autoimmunity; Humans; Immunoglobulins, Intravenous; Palliative Care; Status Epilepticus
PubMed: 32705422
DOI: 10.1007/s40263-020-00747-z -
Acta Neurochirurgica Apr 2019A randomized controlled trial (RCT) remains the pinnacle of clinical research design. However, RCTs in neurosurgery, especially those comparing surgery to non-operative...
BACKGROUND
A randomized controlled trial (RCT) remains the pinnacle of clinical research design. However, RCTs in neurosurgery, especially those comparing surgery to non-operative treatment, are rare and their relevance and applicability have been questioned. This study set out to assess trial design and quality and identify their influence on outcomes in recent neurosurgical trials that compare surgery to non-operative treatment.
METHODS
From 2000 to 2017, PubMed and Embase databases and four trial registries were searched. RCTs were evaluated for study design, funding, adjustments to reported outcome measures, accrual of patients, and academic impact.
RESULTS
Eighty-two neurosurgical RCTs were identified, 40 in spine disorders, 19 neurovascular and neurotrauma, 11 functional neurosurgery, ten peripheral nerve, and two pituitary surgery. Eighty-four RCTs were registered, of which some are ongoing. Trial registration rate differed per subspecialty. Funding was mostly from non-industry institutions (58.5%), but 25.6% of RCTs did not report funding sources. 36.4% of RCTs did not report a difference between surgical and non-operative treatment, 3.7% favored non-operative management. Primary and secondary outcome measures were changed in 13.2% and 34.2% of RCTs respectively and varied by subspecialty. 41.9% of RCTs subtracted ≥ 10% of the anticipated accrual and 12.9% of RCTs added ≥ 10%. 7.3% of registered RCTs were terminated, mostly due to too slow recruitment. Subspecialty, registration, funding, masking, population size, and changing outcome measures were not significantly associated with a reported benefit of surgery. High Jadad scores (≥ 4) were negatively associated with a demonstration of surgical benefit (P < 0.05).
CONCLUSIONS
Neurosurgical RCTs comparing surgical to non-operative treatment often find a benefit for surgical treatment. Changes to outcome measurements and anticipated accrual are common and funding sources are not always reported.
Topics: Humans; Neurosurgical Procedures; Postoperative Complications; Randomized Controlled Trials as Topic
PubMed: 30798479
DOI: 10.1007/s00701-019-03849-w -
Deutsches Arzteblatt International Jun 2018The patient's consent to a medical procedure must be preceded by a pre-procedure discussion with the physician that is documented on a standardized form. Evidence...
BACKGROUND
The patient's consent to a medical procedure must be preceded by a pre-procedure discussion with the physician that is documented on a standardized form. Evidence suggests that these forms lack information that would be relevant for an informed decision.
METHODS
We carried out a systematic literature search up to February 2017 for evidence on the quality and efficacy of informed consent forms. The definition of criteria for the evaluation of meta-information, content, and presentation were derived from current guidelines for evidence-based health information. As an example, we analyzed consent forms currently in use in Germany for 10 medical interventions with regard to decisionally relevant content and intelligibility of format.
RESULTS
Our literature search yielded 14 content analyses, which revealed that even some of the more important evaluative criteria were not always met, including information on benefits (9/14), risks (14/14), alternatives (11/14), the option of doing nothing (6/14), and numerical frequencies (2/14). All analyses indicated deficiencies in the content of the consent forms. We then analyzed 37 consent forms obtained from publishing companies (across Germany) and physician's practices in Hamburg. These forms were found to contain information on: the intervention (37/37), benefits (30/37), risks (37/37), alternatives (26/37), the option of doing nothing (4/37), numerical frequencies (10/37), the names of the authors (17/37), sources of information (0/37), and date of issue (21/37).
CONCLUSION
Both the evidence from foreign countries and our own analysis of the consent forms now in use in Germany revealed deficiencies, particularly in the communication of risks. New standards are needed to promote well-informed decision-making. Structural changes in the process of patient information and decision-making should be discussed.
Topics: Evaluation Studies as Topic; Forms as Topic; Germany; Humans; Informed Consent
PubMed: 29932049
DOI: 10.3238/arztebl.2018.0377 -
TheScientificWorldJournal 2018Hepatitis D virus (HDV) infection has been considered a serious neglected pandemic, particularly in developing countries. The virus causes a more severe disease than... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Hepatitis D virus (HDV) infection has been considered a serious neglected pandemic, particularly in developing countries. The virus causes a more severe disease than mono infection with hepatitis B virus (HBV). The epidemiology of HDV is not well documented in North Africa, which is known to be endemic for HBV. In this study, we explored the prevalence of HDV infection and also attempted to identify factors associated with hepatitis D positive status among chronic hepatitis B patients in North Africa.
METHODS
The electronic databases PubMed, Embase, Scopus, Science Direct, Web of Science, and Google Scholar were comprehensively searched for all papers published between January 1, 1998, and December 31, 2017, using appropriate strategies containing all related keywords, including North Africa, names of countries in the region, and all permutations of hepatitis D virus. The estimated prevalence of HDV in North Africa was calculated as an average of the pooled infection prevalence in each country weighted by the ratio of the country's hepatitis D virus population to the study's sample size in the survey data analysis.
FINDINGS
A total of 312 studies were identified and 32 were included in this study, with a total sample of 4907 individuals screened for HDV. There was considerable variability in the prevalence estimates of HDV within the countries of the region. The overall prevalence of HDV in the general population of North Africa was 5·01% (95% CI: 1·25-8·27) and in liver disease patients it was 20.7% (95% CI:9.87-44.53). Genotype-1 was the most prominent genotype reported in five published studies. Ten studies reported on HDV RNA in participants who were seropositive for HDV, and four studies highlighted the impact of demographic factors (sex and age). No study showed the impact of risk factors on the prevalence of HDV in North Africa.
INTERPRETATION
This review provides a comprehensive assessment of the burden of HDV in Northern Africa. There were significant differences in seroprevalence, study population, and diagnostic testing between the countries in the region. The results presented here will alert health professionals to implement clear policies based on evidence to diminish the burden of HDV infection. Such measures may include but are not restricted to improving the laboratory diagnostic tests and initiating patient data registries and blood screening. Further epidemiological and research studies are needed to explore the risk factors, coinfections, and approaches to increase testing for HDV, particularly in high-risk subpopulations, such as intravenous drug users and immigrants, and to define the consequences of HDV infection in North Africa.
Topics: Africa, Northern; Cost of Illness; Databases, Factual; Emigration and Immigration; Hepatitis D; Hepatitis Delta Virus; Humans; Substance Abuse, Intravenous
PubMed: 30356409
DOI: 10.1155/2018/9312650 -
Addictive Behaviors Sep 2019We conducted a systematic review of the literature on cigar research on youth to identify potential future research agenda to generate evidence to inform cigar...
INTRODUCTION
We conducted a systematic review of the literature on cigar research on youth to identify potential future research agenda to generate evidence to inform cigar regulations to prevent cigar use among youth.
METHODS
We searched articles on Medline, EMBASE, and PsycINFO in April 2017 to identify articles relevant to cigars and adolescents. Two independent coders examined 48 articles to determine eligibility: (1) published between 2000-April 2017; (2) published in English; (3) conducted in the United States; (4) published in a peer-review journal; (5) examined cigars, cigarillos, or little cigars; (6) included youth (12-18 years old); and (7) included empirical data. Three independent coders reviewed the included articles (n = 48) to identify whether the studies addressed FDA's Research Priorities.
RESULTS
The studies addressed FDA's Research Priorities of "behavior" (n = 48), "communications" (n = 4), "marketing influences" (n = 1), and "impact analysis" (n = 1). Studies on "behavior" underscored the need for improvements in measurement, such as using brand names and distinguishing cigar products. The review revealed the need for restrictions on cigar flavors, development of media campaigns and interventions, increasing the cost (via taxation), and evaluating the impact of cigar policies.
CONCLUSIONS
The studies mostly focused on surveillance of behaviors and use patterns, which revealed cigar specific issues to address in policies to decrease cigar use among youth. The lack of studies addressing other FDA's research priorities highlighted the critical need for future studies that inform prevention of youth cigar use.
Topics: Adolescent; Adolescent Behavior; Cigar Smoking; Communication; Humans; Marketing; Public Policy; Research; Smoking Cessation; Smoking Prevention; Tobacco Products; United States; United States Food and Drug Administration
PubMed: 31125939
DOI: 10.1016/j.addbeh.2019.04.032 -
Journal of Orthopaedic Surgery and... Jan 2021Periprosthetic fractures of the distal femur above a total knee arthroplasty (TKA) have traditionally been managed by locking compression plating (LCP). This technique... (Comparative Study)
Comparative Study Meta-Analysis
Locked compression plating versus retrograde intramedullary nailing in the treatment of periprosthetic supracondylar knee fractures: a systematic review and meta-analysis.
BACKGROUND
Periprosthetic fractures of the distal femur above a total knee arthroplasty (TKA) have traditionally been managed by locking compression plating (LCP). This technique is technically demanding and is associated with high rates of non-union and revision. More recently, retrograde intramedullary nailing (RIMN) has been proposed as an acceptable alternative. This meta-analysis aims to evaluate clinical outcomes in patients with periprosthetic supracondylar femoral fractures who were treated with LCP and RIMN.
METHODS
An up-to-date literature search was carried out using the pre-defined search strategy. All studies that met the inclusion criteria were assessed for methodological quality with the Cochrane's collaboration tool. Operative time, functional score, time-to-union, non-union rates and revision rates were all considered.
CONCLUSION
Ten studies with a total of 531 periprosthetic fractures were included. This meta-analysis has suggested that there is no significant difference in any of the outcome measures assessed. Further, more extensive literature is required on the subject to draw more robust conclusions.
Topics: Aged; Arthroplasty, Replacement, Knee; Bone Nails; Bone Plates; Female; Femoral Fractures; Fracture Fixation, Internal; Fracture Fixation, Intramedullary; Humans; Male; Periprosthetic Fractures; Treatment Outcome
PubMed: 33482862
DOI: 10.1186/s13018-021-02222-x