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Cureus May 2024Globally, mental disorders have become a significant burden, affecting a substantial number of individuals. Accessing mental health services is crucial for effective... (Review)
Review
Globally, mental disorders have become a significant burden, affecting a substantial number of individuals. Accessing mental health services is crucial for effective treatment and improving outcomes. However, significant barriers to seeking health services can impede access and contribute to the treatment gap. This systematic review aims to identify and analyze the perceived barriers to seeking mental health services in Saudi Arabia. A comprehensive search was conducted among four databases (PubMed, Web of Science, ProQuest, and Science Direct) to identify relevant studies published between 2018 and 2023. Studies that investigated barriers that could prevent psychiatric patients from seeking mental health services in Saudi Arabia were included. Data extraction and synthesis were performed to identify common themes and barriers. The review included a total of six studies that examined barriers to seeking mental health services in Saudi Arabia. The identified barriers encompassed a range of factors, including stigma, lack of awareness, concerns about confidentiality, limited availability of services, negative attitudes toward professional help, and cultural and religious beliefs. The lack of knowledge, as well as the negative attitude toward mental health care, was a perceived barrier to help-seeking in most studies. Furthermore, stigma was consistently reported as a predominant barrier, preventing individuals from seeking mental health care. This systematic review highlights the barriers to seeking mental health services in Saudi Arabia. Addressing these barriers is essential for improving access to mental healthcare and reducing the treatment gap. Strategies should focus on destigmatization efforts, increasing awareness, ensuring confidentiality and privacy, providing culturally appropriate care, and addressing structural limitations. By implementing these strategies, healthcare systems can improve access to mental health care and the overall well-being of individuals experiencing mental disorders in Saudi Arabia.
PubMed: 38883041
DOI: 10.7759/cureus.60363 -
Frontiers in Public Health 2023Blockchain technology includes numerous elements such as distributed ledgers, decentralization, authenticity, privacy, and immutability. It has progressed past the hype...
Blockchain technology includes numerous elements such as distributed ledgers, decentralization, authenticity, privacy, and immutability. It has progressed past the hype to find actual use cases in industries like healthcare. Blockchain is an emerging area that relies on a consensus algorithm and the idea of a digitally distributed ledger to eliminate any intermediary risks. By enabling them to trace data provenance and any changes made, blockchain technology can enable different healthcare stakeholders to share access to their networks without violating data security and integrity. The healthcare industry faces challenges like fragmented data, security and privacy concerns, and interoperability issues. Blockchain technology offers potential solutions by ensuring secure, tamper-proof storage across multiple network nodes, improving interoperability and patient privacy. Encrypting patient data further enhances security and reduces unauthorized access concerns. Blockchain technology, deployed over the Internet, can potentially use the current healthcare data by using a patient-centric approach and removing the intermediaries. This paper discusses the effective utilization of blockchain technology in the healthcare industry. In contrast to other applications, the exoteric evaluation in this paper shows that the innovative technology called blockchain technology has a major role to play in the existing and future applications of the healthcare industry and has significant benefits.
Topics: Humans; Blockchain; Electronic Health Records; Computer Security; Delivery of Health Care; Confidentiality
PubMed: 37790716
DOI: 10.3389/fpubh.2023.1229386 -
Saudi Journal of Anaesthesia 2024This review article examines the utility of artificial intelligence (AI) in anesthesia, with a focus on recent developments and future directions in the field. A total... (Review)
Review
This review article examines the utility of artificial intelligence (AI) in anesthesia, with a focus on recent developments and future directions in the field. A total of 19,300 articles were available on the given topic after searching in the above mentioned databases, and after choosing the custom range of years from 2015 to 2023 as an inclusion component, only 12,100 remained. 5,720 articles remained after eliminating non-full text. Eighteen papers were identified to meet the inclusion criteria for the review after applying the inclusion and exclusion criteria. The applications of AI in anesthesia after studying the articles were in favor of the use of AI as it enhanced or equaled human judgment in drug dose decision and reduced mortality by early detection. Two studies tried to formulate prediction models, current techniques, and limitations of AI; ten studies are mainly focused on pain and complications such as hypotension, with a P value of <0.05; three studies tried to formulate patient outcomes with the help of AI; and three studies are mainly focusing on how drug dose delivery is calculated (median: 1.1% ± 0.5) safely and given to the patients with applications of AI. In conclusion, the use of AI in anesthesia has the potential to revolutionize the field and improve patient outcomes. AI algorithms can accurately predict patient outcomes and anesthesia dosing, as well as monitor patients during surgery in real time. These technologies can help anesthesiologists make more informed decisions, increase efficiency, and reduce costs. However, the implementation of AI in anesthesia also presents challenges, such as the need to address issues of bias and privacy. As the field continues to evolve, it will be important to carefully consider the ethical implications of AI in anesthesia and ensure that these technologies are used in a responsible and transparent manner.
PubMed: 38654854
DOI: 10.4103/sja.sja_955_23 -
Digital Health 2024Electronic mental health interventions are effective but not well promoted currently among older adults. This study sought to systematically review and summarize the... (Review)
Review
OBJECTIVE
Electronic mental health interventions are effective but not well promoted currently among older adults. This study sought to systematically review and summarize the barriers and facilitators of accepting and implementing electronic mental health interventions among older adults.
METHODS
We comprehensively retrieved six electronic databases from January 2012 to September 2022: PubMed, Web of Science, Embase, Scopus, PsycINFO, and CINAHL. The JBI-QARI was used to assess the quality of the research methodology of each publication. Eligible studies underwent data coding and synthesis aligned to inductive and deductive methods. The Consolidated Framework for Implementation Research 2.0 was used as a deductive framework to guide a more structured analysis.
RESULTS
The systematic review screened 4309 articles, 17 of which were included (eight with mixed methods and nine with qualitative methods). We identified and extracted the barriers and facilitators of accepting and implementing electronic mental health interventions among older adults: (1) innovation: technology challenges, optimized functions, and contents, security and privacy; (2) outer setting: community engagement and partnerships, financing; (3) inner setting: leadership engagement, available resources, incompatibility, intergenerational support, training and guidance; (4) individuals: perceptions, capability, motivation of older adults and healthcare providers; and (5) implementation process: recruit, external assistance, and team.
CONCLUSION
These findings are critical to optimizing, promoting, and expanding electronic mental health interventions among older adults. The systematic review also provides a reference for better evidence-based implementation strategies in the future.
PubMed: 38444518
DOI: 10.1177/20552076241234628 -
Diagnostic and Interventional Imaging 2024The purpose of this study was to systematically review the reported performances of ChatGPT, identify potential limitations, and explore future directions for its... (Review)
Review
PURPOSE
The purpose of this study was to systematically review the reported performances of ChatGPT, identify potential limitations, and explore future directions for its integration, optimization, and ethical considerations in radiology applications.
MATERIALS AND METHODS
After a comprehensive review of PubMed, Web of Science, Embase, and Google Scholar databases, a cohort of published studies was identified up to January 1, 2024, utilizing ChatGPT for clinical radiology applications.
RESULTS
Out of 861 studies derived, 44 studies evaluated the performance of ChatGPT; among these, 37 (37/44; 84.1%) demonstrated high performance, and seven (7/44; 15.9%) indicated it had a lower performance in providing information on diagnosis and clinical decision support (6/44; 13.6%) and patient communication and educational content (1/44; 2.3%). Twenty-four (24/44; 54.5%) studies reported the proportion of ChatGPT's performance. Among these, 19 (19/24; 79.2%) studies recorded a median accuracy of 70.5%, and in five (5/24; 20.8%) studies, there was a median agreement of 83.6% between ChatGPT outcomes and reference standards [radiologists' decision or guidelines], generally confirming ChatGPT's high accuracy in these studies. Eleven studies compared two recent ChatGPT versions, and in ten (10/11; 90.9%), ChatGPTv4 outperformed v3.5, showing notable enhancements in addressing higher-order thinking questions, better comprehension of radiology terms, and improved accuracy in describing images. Risks and concerns about using ChatGPT included biased responses, limited originality, and the potential for inaccurate information leading to misinformation, hallucinations, improper citations and fake references, cybersecurity vulnerabilities, and patient privacy risks.
CONCLUSION
Although ChatGPT's effectiveness has been shown in 84.1% of radiology studies, there are still multiple pitfalls and limitations to address. It is too soon to confirm its complete proficiency and accuracy, and more extensive multicenter studies utilizing diverse datasets and pre-training techniques are required to verify ChatGPT's role in radiology.
Topics: Humans; Radiology; Forecasting
PubMed: 38679540
DOI: 10.1016/j.diii.2024.04.003 -
JMIR Cancer Jan 2024Breast cancer is a widespread disease, and its incidence is rapidly increasing in the Middle East and North Africa region. With the increasing availability of smartphone...
BACKGROUND
Breast cancer is a widespread disease, and its incidence is rapidly increasing in the Middle East and North Africa region. With the increasing availability of smartphone apps for various health purposes, breast cancer apps have emerged as tools for raising awareness, providing support, and empowering women affected by this disease. These apps offer many features, including information on breast cancer risk factors, self-examination guides, appointment reminders, and community support groups or hotlines. Using apps raises the risk of privacy and security issues, and we hope that examining these features of the apps will contribute to the understanding of how technology can be used to improve these apps and provide insights for future development and improvement of breast cancer apps.
OBJECTIVE
This study aims to critically review the quality, privacy, and security of breast cancer apps available to Arabic speakers.
METHODS
Similar to several recent studies, we used a systematic search for apps available in Google Play and Apple App stores using both the web interface and the built-in native stores installed on smartphones. The search was conducted in mid-December 2022 in Arabic using the following keywords: سرطان الثدي - فحص سرطان الثدي - علاج سرطان الثدي - مرض سرطان الثدي - أعراض سرطان الثدي - فحص الثدي (breast cancer, breast cancer treatment, breast cancer disease, breast cancer symptoms, breast cancer screening, and breast test). These preidentified search terms are based on earlier work concerning the top searched breast cancer topics by Arabic speakers through Google's search engine. We excluded apps that did not have an Arabic interface, were developed for non-Arabic speakers, were paid, needed a subscription, or were directed toward health care workers. The Mobile App Rating Scale was used to evaluate the quality of the apps concerning their engagement, functionality, aesthetics, and information. A risk score was calculated for the apps to determine their security risk factors.
RESULTS
Only 9 apps were included, with most (6/9, 67%) being supported by advertisements and categorized as informational. Overall, the apps had low numbers of downloads (>10 to >1000). The majority of the included apps (8/9, 89%) requested dangerous access permissions, including access to storage, media files, and the camera. The average security score of the included apps was 3.22, while only 2 apps provided information about data security and privacy. The included apps achieved an overall average quality score of 3.27, with individual dimension scores of 4.75 for functionality, 3.04 for information, 3.00 for aesthetics, and 2.32 for engagement.
CONCLUSIONS
The limited availability of breast cancer apps available to Arabic speakers should be a call to action and prompt health care organizations and developers to join forces and collaboratively develop information-rich, usable, functional, engaging, and secure apps.
PubMed: 38227353
DOI: 10.2196/48428 -
The Permanente Journal Dec 2023Remote patient monitoring (RPM), or telemonitoring, offers ways for health care practitioners to gather real-time information on the physiological conditions of...
BACKGROUND
Remote patient monitoring (RPM), or telemonitoring, offers ways for health care practitioners to gather real-time information on the physiological conditions of patients. As telemedicine, and thus telemonitoring, is becoming increasingly relevant in today's society, understanding the practitioners' opinions is crucial. This systematic review evaluates the perspectives and experiences of health care practitioners with telemonitoring technologies.
METHODS
A database search was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines for the selection of articles measuring health care practitioners' perspectives and experiences with RPM technologies published between 2017 and 2021. Only articles written in English were included. No statistical analysis was performed and thus this is a qualitative review.
RESULTS
A total of 1605 studies were identified after the initial search. After applying the inclusion and exclusion criteria of this review's authors, 13 articles were included in this review. In all, 2351 practitioners' perspectives and experience utilizing RPM technology in a variety of medical specialties were evaluated through close- and open-ended surveys. Recurring themes emerged for both the benefits and challenges. Common benefits included continuous monitoring of patients to provide prompt care, improvement of patient self-care, efficient communication, increased patient confidence, visualization of health trends, and greater patient education. Challenges comprised increased workload, higher patient anxiety, data inaccuracy, disorienting technology, financial issues, and privacy concerns.
CONCLUSION
Health care practitioners generally believe that RPM is feasible for application. Additionally, there is a consensus that telemonitoring strategies will become increasingly relevant. However, there are still drawbacks to the technology that need to be considered.
Topics: Humans; Delivery of Health Care; Monitoring, Physiologic; Telemedicine
PubMed: 37735970
DOI: 10.7812/TPP/23.022 -
International Journal of Hygiene and... Jul 2024Shared sanitation facilities are not considered a type of basic sanitation by the WHO/UNICEF Joint Monitoring Programme (JMP), though they may be the only alternative to... (Meta-Analysis)
Meta-Analysis
Shared sanitation facilities are not considered a type of basic sanitation by the WHO/UNICEF Joint Monitoring Programme (JMP), though they may be the only alternative to open defecation in urban informal settlements. Additionally, JMP indicators for sanitation do not cover aspects related to the quality of shared sanitation, such as those outlined in the Human Right to Water and Sanitation (HRTWS) framework. Data on the prevalence of shared sanitation within informal settlement areas is limited, and there is a need to understand user preferences, experiences, and barriers to the use of shared sanitation to inform effective policy and practice. This systematic review aims to summarize the prevalence and number of households sharing sanitation in informal settlements globally, as well as user experiences and barriers to successful implementation of shared sanitation. We included studies available in English and published after January 1, 2000. We retrieved 4741 articles from seven databases and included a total of 167 relevant publications. Among included studies, 54 reported the prevalence of shared sanitation in informal settlements, and 138 studies reported on user perceptions and experiences related to shared sanitation quality. A meta-analysis of studies reporting the prevalence of shared sanitation in informal settlements globally revealed an estimated overall prevalence of 67% [95% CI: 61%-73%]. Commonly reported user preferences included cleanliness to promote continued use of shared facilities, privacy with a lockable door, facilities for menstrual hygiene management, safety and protection against violence, 24/7 access, proper lighting, and shared responsibility for facility management - which align with the HRTWS framework and represent barriers to shared sanitation use. Based on the findings of this review, we recommend including the number of households or people sharing a sanitation facility in monitoring of shared sanitation quality, locating sanitation facilities within compounds, where applicable, and promoting safety, dignity, and privacy of all users in the development of shared sanitation quality indicators.
Topics: Humans; Prevalence; Sanitation
PubMed: 38788338
DOI: 10.1016/j.ijheh.2024.114392 -
NPJ Digital Medicine Jul 2023Digital health, including telemedicine, has increased access to abortion care. The convenience, flexibility of appointment times, and ensured privacy to abortion users... (Review)
Review
Digital health, including telemedicine, has increased access to abortion care. The convenience, flexibility of appointment times, and ensured privacy to abortion users may make abortion services via telemedicine preferable. This scoping review systematically mapped studies conducted on abortion services via telemedicine, including their effectiveness and acceptability for abortion users and providers. All published papers included abortion services via telemedicine in the United States were considered. Articles were searched in PubMed, CINAHL, and Google Scholar databases in September 2022. The findings were synthesized narratively, and the PRISMA-ScR guidelines were used to report this study. Out of 757 retrieved articles, 33 articles were selected based on the inclusion criteria. These studies were published between 2011 and 2022, with 24 published in the last 3 years. The study found that telemedicine increased access to abortion care in the United States, especially for people in remote areas or those worried about stigma from in-person visits. The effectiveness of abortion services via telemedicine was comparable to in-clinic visits, with 6% or fewer abortions requiring surgical intervention. Both care providers and abortion seekers expressed positive perceptions of telemedicine-based abortion services. However, abortion users reported mixed emotions, with some preferring in-person visits. The most common reasons for choosing telemedicine included the distance to the abortion clinic, convenience, privacy, cost, flexibility of appointment times, and state laws imposing waiting periods or restrictive policies. Telemedicine offered a preferable option for abortion seekers and providers. The feasibility of accessing abortion services via telemedicine in low-resource settings needs further investigation.
PubMed: 37438435
DOI: 10.1038/s41746-023-00871-2 -
Digital Health 2024Many clinical trials fail because of poor recruitment and enrollment which can directly impact the success of biomedical and clinical research outcomes. Options to... (Review)
Review
BACKGROUND
Many clinical trials fail because of poor recruitment and enrollment which can directly impact the success of biomedical and clinical research outcomes. Options to leverage digital technology for improving clinical trial management are expansive, with potential benefits for improving access to clinical trials, encouraging trial diversity and inclusion, and potential cost-savings through enhanced efficiency.
OBJECTIVES
This systematic review has two key aims: (1) identify and describe the digital technologies applied in clinical trial recruitment and enrollment and (2) evaluate evidence of these technologies addressing the recruitment and enrollment of racial and ethnic minority groups.
METHODS
We conducted a cross-disciplinary review of articles from PubMed, IEEE Xplore, and ACM Digital Library, published in English between January 2012 and July 2022, using MeSH terms and keywords for digital health, clinical trials, and recruitment and enrollment. Articles unrelated to technology in the recruitment/enrollment process or those discussing recruitment/enrollment without technology aspects were excluded.
RESULTS
The review returned 614 results, with 21 articles (four reviews and 17 original research articles) deemed suitable for inclusion after screening and full-text review. To address the first objective, various digital technologies were identified and characterized, which included articles with more than one technology subcategory including (a) multimedia presentations (19%, = 4); (b) mobile applications (14%, = 3); (c) social media platforms (29%, = 6); (d) machine learning and computer algorithms (19%, = 4); (e) e-consenting (24%, = 5); (f) blockchain (5%, = 1); (g) web-based programs (24%, = 5); and (h) virtual messaging (24%, = 5). Additionally, subthemes, including specific diseases or conditions addressed, privacy and regulatory concerns, cost/benefit analyses, and ethnic and minority recruitment considerations, were identified and discussed. Limited research was found to support a particular technology's effectiveness in racial and ethnic minority recruitment and enrollment.
CONCLUSION
Results from this review illustrate that several types of technology are currently being explored and utilized in clinical trial recruitment and enrollment stages. However, evidence supporting the use of digital technologies is varied and requires further research and evaluation to identify the most valuable opportunities for encouraging diversity in clinical trial recruitment and enrollment practices.
PubMed: 38559578
DOI: 10.1177/20552076241242390