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The British Journal of Radiology Dec 2023Technological advancements in computer science have started to bring artificial intelligence (AI) from the bench closer to the bedside. While there is still lots to do... (Review)
Review
Technological advancements in computer science have started to bring artificial intelligence (AI) from the bench closer to the bedside. While there is still lots to do and improve, AI models in medical imaging and radiotherapy are rapidly being developed and increasingly deployed in clinical practice. At the same time, AI governance frameworks are still under development. Clinical practitioners involved with procuring, deploying, and adopting AI tools in the UK should be well-informed about these AI governance frameworks. This scoping review aimed to map out available literature on AI governance in the UK, focusing on medical imaging and radiotherapy. Searches were performed on Google Scholar, Pubmed, and the Cochrane Library, between June and July 2022. Of 4225 initially identified sources, 35 were finally included in this review. A comprehensive conceptual AI governance framework was proposed, guided by the need for rigorous AI validation and evaluation procedures, the accreditation rules and standards, and the fundamental ethical principles of AI. Fairness, transparency, trustworthiness, and explainability should be drivers of all AI models deployed in clinical practice. Appropriate staff education is also mandatory to ensure AI's safe and responsible use. Multidisciplinary teams under robust leadership will facilitate AI adoption, and it is crucial to involve patients, the public, and practitioners in decision-making. Collaborative research should be encouraged to enhance and promote innovation, while caution should be paid to the ongoing auditing of AI tools to ensure safety and clinical effectiveness.
Topics: Humans; Artificial Intelligence; Diagnostic Imaging; Radiation Oncology; Radiography; United Kingdom
PubMed: 37747285
DOI: 10.1259/bjr.20221157 -
Digital Health 2024Technology plays a substantial role in our daily lives, and the spread of COVID-19 paves the way for the use of healthcare technologies to manage health in the comfort...
Technology plays a substantial role in our daily lives, and the spread of COVID-19 paves the way for the use of healthcare technologies to manage health in the comfort of our homes. Middle-aged and older adults face health issues and require instant healthcare advice and support. Electronic healthcare (EH) applications have emerged to facilitate middle-aged and older adults receiving healthcare support instantly while remaining in their homes. The present study empirically evaluates the intention and adoption of electronic health applications with the technological attributes of perceived compatibility, cost, product value, technology accuracy, privacy issues and health motivation among middle-aged and older adults from Malaysia. Moreover, this research examines the mediating effect of the intention to adopt EH applications between technology attributes and the adoption of EH applications. This study uses a cross-sectional method and employs an online survey to assemble quantitative data from 298 middle-aged and older Malaysian adults. It utilizes partial least squares structural equation modelling for data analysis. The data analysis reveals that perceived compatibility, cost, privacy, product value and health motivation significantly influenced the intention to use EH apps. Furthermore, the analysis shows that the intention to adopt EH apps significantly mediates the relationship between the perception of cost, personal privacy, product value, health motivation and adoption of EH apps. However, the intention to use EH apps insignificantly instigates their adoption. Finally, the study presents its implications, limitations and future research directions.
PubMed: 38449679
DOI: 10.1177/20552076241237499 -
Euro Surveillance : Bulletin Europeen... Nov 2023Many organisations struggle to keep pace with public health evidence due to the volume of published literature and length of time it takes to conduct literature reviews.... (Review)
Review
Many organisations struggle to keep pace with public health evidence due to the volume of published literature and length of time it takes to conduct literature reviews. New technologies that help automate parts of the evidence synthesis process can help conduct reviews more quickly and efficiently to better provide up-to-date evidence for public health decision making. To date, automated approaches have seldom been used in public health due to significant barriers to their adoption. In this Perspective, we reflect on the findings of a study exploring experiences of adopting automated technologies to conduct evidence reviews within the public health sector. The study, funded by the European Centre for Disease Prevention and Control, consisted of a literature review and qualitative data collection from public health organisations and researchers in the field. We specifically focus on outlining the challenges associated with the adoption of automated approaches and potential solutions and actions that can be taken to mitigate these. We explore these in relation to actions that can be taken by tool developers (e.g. improving tool performance and transparency), public health organisations (e.g. developing staff skills, encouraging collaboration) and funding bodies/the wider research system (e.g. researchers, funding bodies, academic publishers and scholarly journals).
Topics: Humans; Public Health; Data Collection
PubMed: 37943502
DOI: 10.2807/1560-7917.ES.2023.28.45.2300183 -
Cureus Dec 2023Wearable insulin biosensors represent a novel approach that combines the benefits of real-time glucose monitoring and automated insulin delivery, potentially...
BACKGROUND
Wearable insulin biosensors represent a novel approach that combines the benefits of real-time glucose monitoring and automated insulin delivery, potentially revolutionizing how individuals with diabetes manage their condition.
STUDY PURPOSE
To analyze the behavioral intentions of wearable insulin biosensors among diabetes patients, the factors that drive or hinder their usage, and the implications for diabetes management and healthcare outcomes.
METHODS
A cross-sectional survey design was adopted in this study. The validated questionnaire included 10 factors (Performance expectancy, effort expectancy, social influence, facilitating conditions, behavioral intention, trust, perceived privacy risk, and personal innovativeness) affecting the acceptance of wearable insulin sensors. A total of 248 diabetic patients who had used wearable sensors participated in the study.
RESULTS
Performance expectancy was rated the highest (Mean = 3.84 out of 5), followed by effort expectancy (Mean = 3.78 out of 5), and trust (Mean = 3.53 out of 5). Statistically significant differences (p < 0.05) were observed with respect to socio-demographic variables including age and gender on various influencing factors and adoption intentions. PE, EE, and trust were positively associated with adoption intentions.
CONCLUSION
While wearable insulin sensors are positively perceived with respect to diabetes management, issues like privacy and security may affect their adoption.
PubMed: 38239544
DOI: 10.7759/cureus.50782 -
BMJ Global Health Oct 2023Global health reciprocal innovations originate in low-income and middle-income countries as well as high-income countries before their developers communicate about them... (Review)
Review
Global health reciprocal innovations originate in low-income and middle-income countries as well as high-income countries before their developers communicate about them with potential adopters in other countries as a transnational team. While communication technology has enabled a more rapid and broader sharing of information about innovations to prevent disease and improve health, innovations of various types have spread among countries, at all levels of income, for many centuries. In this article, we introduce the idea of reciprocal coproduction as a basis for the international sharing of information about innovations that exhibit potential for improving global health. Reciprocal coproduction occurs through two relational team-based processes: developer-led reinvention of an innovation so that it retains its desirable causal effects and implementer-led adaptation of that innovation so that it is compatible with new contexts into which it is introduced. Drawing on research and our own experiences across a range of health issues, we discuss common barriers to reciprocal coproduction and the diffusion of reciprocal innovations. We conclude with lessons drawn from dissemination and implementation science about the effective translation of reciprocal innovations from country to country so that researchers, policy-makers and social entrepreneurs can best ensure equity, accelerate adoptions and heighten the likelihood that global health reciprocal innovations will make a positive difference in health.
Topics: Humans; Diffusion of Innovation; Global Health; Income; Poverty
PubMed: 37793816
DOI: 10.1136/bmjgh-2023-013134 -
Journal of Medical Internet Research Dec 2023Electronic health record (EHR) systems have been shown to be associated with improvements in care processes, quality of care, and patient outcomes. EHR also has a...
BACKGROUND
Electronic health record (EHR) systems have been shown to be associated with improvements in care processes, quality of care, and patient outcomes. EHR also has a crucial role in the delivery of substance use disorder (SUD) treatment and is considered important for addressing SUD crises, including the opioid epidemic. However, little is known about the adoption of EHR in SUD treatment programs or the organizational-level factors associated with the adoption of EHR in SUD treatment.
OBJECTIVE
We examined the adoption of EHR in SUD programs, with a focus on changes in adoption from 2014 to 2017, and identified organizational-level factors associated with EHR adoption.
METHODS
We used data from the 2014 and 2017 National Drug Abuse Treatment System Surveys. Our analysis included 1027 SUD programs (531 in 2014 and 496 in 2017). We used chi-square and Mann-Whitney U tests for categorical and continuous variables, respectively, to assess changes in EHR adoption, technology use, program, and client characteristics. We also investigated differences in characteristics and barriers to adoption by EHR adoption status (adopted EHR vs had not adopted or were planning to adopt EHR). We then conducted multivariate logistic regressions to examine internal and external factors associated with EHR adoption.
RESULTS
The adoption of EHR increased significantly from 57.6% (306/531) in 2014 to 69.2% (343/496) in 2017 (P<.001), showing that nearly one-third (153/496, 30.8%) of SUD programs had not yet adopted an EHR system by 2017. We identified a significant increase in technology use and ownership by a parent company (P=.01 and P<.001) and a decrease in the percentage of uninsured patients in 2017 (P<.001), compared to 2014. Our analysis further showed significant differences by adoption status for three major barriers to adoption: (1) start-up costs, (2) ongoing financial costs, and (3) privacy or security concerns (P<.001). Programs that used computerized scheduling (adjusted odds ratio [AOR] 3.02, 95% CI 2.23-4.09) and billing systems (AOR 2.29, 95% CI 1.62-3.25) were more likely to adopt EHR. Similarly, ownership type, such as private nonprofit (AOR 1.86, 95% CI 1.31-2.65) and public (AOR 2.14, 95% CI 1.27-3.67), or interest in participating in a patient-centered medical home (AOR 1.93, 95% CI 1.29-2.92), were associated with an increased likelihood to adopt EHR. Overall, SUD programs were more likely to adopt an EHR system in 2017 compared to 2014 (AOR 1.44, 95% CI 1.07-1.94).
CONCLUSIONS
Our findings highlighted that SUD programs may be on track to achieve widespread EHR adoption. However, there is a need for focused strategies, resources, and policies explicitly designed to systematically address barriers and tackle obstacles to expanding the adoption of EHR systems. These efforts must be holistic and address factors at multiple organizational levels.
Topics: Humans; Electronic Health Records; Cross-Sectional Studies; Surveys and Questionnaires; Odds Ratio; Substance-Related Disorders
PubMed: 38096006
DOI: 10.2196/45238 -
Healthcare Informatics Research Jul 2023The adoption of electronic dental records (EDRs) is less extensively studied than electronic medical records (EMRs) in Saudi Arabia. Therefore, a multivariate analysis...
OBJECTIVES
The adoption of electronic dental records (EDRs) is less extensively studied than electronic medical records (EMRs) in Saudi Arabia. Therefore, a multivariate analysis was conducted to calculate the adoption of EDRs and determine the practice characteristics that influence adoption.
METHODS
An online survey was conducted with 220 dental practices in Jeddah from August to December 2021. The questionnaire contained 10 items that measured the adoption of EDRs and identified the region, district, practice characteristics, and practice size. A regression analysis was used to ascertain the relationships between EDR adoption and the predictor variables.
RESULTS
About 93% of the dental practices, we surveyed in Jeddah had adopted EDRs. Public dental practices and large practices were associated with higher rates of adoption (respectively, 97.0%, p = 0.016; 97.8%, p = 0.009). The logistic regression model showed statistically significant results regarding practice characteristics, practice size, and the acceptance of insurance patients. EDR adoption was 89% less likely for private dental practices, 99% less likely for smaller dental practices (≥2 dentists), and 98% less likely in dental practices that did not treat patients with insurance.
CONCLUSIONS
Our study sample showed a high rate of EDR adoption. Among the participants, public practices, large practices, and practices that treat patients with insurance were the most positively inclined toward EDR adoption.
PubMed: 37591679
DOI: 10.4258/hir.2023.29.3.239 -
BMC Health Services Research Sep 2023The digitalization studies in public hospitals in Türkiye started with the Health Transformation Program in 2003. As digitalization was accomplished, the policymakers...
BACKGROUND
The digitalization studies in public hospitals in Türkiye started with the Health Transformation Program in 2003. As digitalization was accomplished, the policymakers needed to measure hospitals' electronic health record (EHR) usage and adoptions. The ministry of health has been measuring the dissemination of meaningful usage and adoption of EHR since 2013 using Electronic Medical Record Adoption Model (EMRAM). The first published study about this analysis covered the surveys applied between 2013 and 2017. The results showed that 63.1% of all hospitals in Türkiye had at least basic EHR functions, and 36% had comprehensive EHR functions. Measuring the countrywide EHR adoption level is becoming popular in the world. This study aims to measure adoption levels of EHR in public hospitals in Türkiye, indicate the change to the previous study, and make a benchmark with other countries measuring national EHR adoption levels. The research question of this study is to reveal whether there has been a change in the adoption level of EHR in the three years since 2018 in Türkiye. Also, make a benchmark with other countries such as the US, Japan, and China in country-wide EHR adoption in 2021.
METHODS
In 2021, 717 public hospitals actively operating in Türkiye completed the EMRAM survey. The survey results, deals with five topics (General Stage Status, Information Technology Security, Electronic Health Record/Clinical Data Repository, Clinical Documentation, Closed-Loop Management), was reviewed by the authors. Survey data were compared according to hospital type (Specialty Hospitals, General Hospitals, Teaching and Research Hospitals) in terms of general stage status. The data obtained from the survey results were analyzed with QlikView Personal Edition. The availability and prevalence of medical information systems and EHR functions and their use were measured.
RESULTS
We found that 33.7% of public hospitals in Türkiye have only basic EHR functions, and 66.3% have extensive EHR functions, which yields that all hospitals (100%) have at least basic EHR functions. That means remarkable progress from the previous study covering 2013 and 2017. This level also indicates that Türkiye has slightly better adoption from the US (96%) and much better than China (85.3%) and Korea (58.1%).
CONCLUSIONS
Although there has been outstanding (50%) progress since 2017 in Turkish public hospitals, it seems there is still a long way to disseminate comprehensive EHR functions, such as closed-loop medication administration, clinical decision support systems, patient engagement, etc. Measuring the stage of EHR adoption at regular intervals and on analytical scales is an effective management tool for policymakers. The bottom-up adoption approach established for adopting and managing EHR functions in the US has also yielded successful results in Türkiye.
Topics: Humans; Electronic Health Records; Hospitals, Public; Benchmarking; China; Decision Support Systems, Clinical
PubMed: 37710253
DOI: 10.1186/s12913-023-09859-w -
PloS One 2023Secured financial transactions can now be conveniently made via mobile devices for various products and services, such as e-hailing. However, limited research exists on...
Secured financial transactions can now be conveniently made via mobile devices for various products and services, such as e-hailing. However, limited research exists on the factors influencing the adoption of mobile payments specifically for e-hailing services, despite the growing interest in mobile payments in China. This cross-sectional study quantitatively assessed the influence of perceived usefulness, perceived ease of use, social influence, facilitating conditions, perceived security, and lifestyle compatibility on the intention to adopt and the actual adoption of mobile payment for e-hailing services. An online self-administered survey was conducted, involving 413 respondents from China. The results revealed a significant positive influence of perceived ease of use, social influence, facilitating conditions, and perceived security on the intention to adopt mobile payment. Additionally, the study found that the intention to adopt mobile payment positively influenced the actual adoption of mobile payments. Meanwhile, perceived usefulness and lifestyle compatibility demonstrated an insignificant influence on the intention to adopt mobile payments. Subgroup analysis further revealed gender-based differences, indicating that the influence of the intention to adopt mobile payment on the adoption of mobile payment for e-hailing services varied significantly between male and female respondents. Furthermore, the influence of facilitating conditions on the intention to adopt mobile payment for e-hailing services also differed significantly among respondents of different age groups. These findings contribute to a better understanding of the factors influencing the adoption of mobile payment for e-hailing services and provide insights for service providers and policymakers in promoting its adoption.
Topics: Male; Humans; Female; Cross-Sectional Studies; Patient Acceptance of Health Care; China; Intention; Surveys and Questionnaires
PubMed: 37831669
DOI: 10.1371/journal.pone.0287300 -
Sports Medicine (Auckland, N.Z.) Dec 2023An eccentrically lengthening, energy-absorbing, brake-driven model of hamstring function during the late-swing phase of sprinting has been widely touted within the... (Review)
Review
An eccentrically lengthening, energy-absorbing, brake-driven model of hamstring function during the late-swing phase of sprinting has been widely touted within the existing literature. In contrast, an isometrically contracting, spring-driven model of hamstring function has recently been proposed. This theory has gained substantial traction within the applied sporting world, influencing understandings of hamstring function while sprinting, as well as the development and adoption of certain types of hamstring-specific exercises. Across the animal kingdom, both spring- and motor-driven muscle-tendon unit (MTU) functioning are frequently observed, with both models of locomotive functioning commonly utilising some degree of active muscle lengthening to draw upon force enhancement mechanisms. However, a method to accurately assess hamstring muscle-tendon functioning when sprinting does not exist. Accordingly, the aims of this review article are three-fold: (1) to comprehensively explore current terminology, theories and models surrounding muscle-tendon functioning during locomotion, (2) to relate these models to potential hamstring function when sprinting by examining a variety of hamstring-specific research and (3) to highlight the importance of developing and utilising evidence-based frameworks to guide hamstring training in athletes required to sprint. Due to the intensity of movement, large musculotendinous stretches and high mechanical loads experienced in the hamstrings when sprinting, it is anticipated that the hamstring MTUs adopt a model of functioning that has some reliance upon active muscle lengthening and muscle actuators during this particular task. However, each individual hamstring MTU is expected to adopt various combinations of spring-, brake- and motor-driven functioning when sprinting, in accordance with their architectural arrangement and activation patterns. Muscle function is intricate and dependent upon complex interactions between musculoskeletal kinematics and kinetics, muscle activation patterns and the neuromechanical regulation of tensions and stiffness, and loads applied by the environment, among other important variables. Accordingly, hamstring function when sprinting is anticipated to be unique to this particular activity. It is therefore proposed that the adoption of hamstring-specific exercises should not be founded on unvalidated claims of replicating hamstring function when sprinting, as has been suggested in the literature. Adaptive benefits may potentially be derived from a range of hamstring-specific exercises that vary in the stimuli they provide. Therefore, a more rigorous approach is to select hamstring-specific exercises based on thoroughly constructed evidence-based frameworks surrounding the specific stimulus provided by the exercise, the accompanying adaptations elicited by the exercise, and the effects of these adaptations on hamstring functioning and injury risk mitigation when sprinting.
Topics: Animals; Humans; Hamstring Muscles; Muscle, Skeletal; Running; Tendons; Biomechanical Phenomena
PubMed: 37668895
DOI: 10.1007/s40279-023-01904-2