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Frontiers in Digital Health 2024In the big data era, where corporations commodify health data, non-fungible tokens (NFTs) present a transformative avenue for patient empowerment and control. NFTs are...
INTRODUCTION
In the big data era, where corporations commodify health data, non-fungible tokens (NFTs) present a transformative avenue for patient empowerment and control. NFTs are unique digital assets on the blockchain, representing ownership of digital objects, including health data. By minting their data as NFTs, patients can track access, monetize its use, and build secure, private health information systems. However, research on NFTs in healthcare is in its infancy, warranting a comprehensive review.
METHODS
This study conducted a systematic literature review and thematic analysis of NFTs in healthcare to identify use cases, design models, and key challenges. Five multidisciplinary research databases (Scopus, Web of Science, Google Scholar, IEEE Explore, Elsevier Science Direct) were searched. The approach involved four stages: paper collection, inclusion/exclusion criteria application, screening, full-text reading, and quality assessment. A classification and coding framework was employed. Thematic analysis followed six steps: data familiarization, initial code generation, theme searching, theme review, theme definition/naming, and report production.
RESULTS
Analysis of 19 selected papers revealed three primary use cases: patient-centric data management, supply chain management for data provenance, and digital twin development. Notably, most solutions were prototypes or frameworks without real-world implementations. Four overarching themes emerged: data governance (ownership, tracking, privacy), data monetization (commercialization, incentivization, sharing), data protection, and data storage. The focus lies on user-controlled, private, and secure health data solutions. Additionally, data commodification is explored, with mechanisms proposed to incentivize data maintenance and sharing. NFTs are also suggested for tracking medical products in supply chains, ensuring data integrity and provenance. Ethereum and similar platforms dominate NFT minting, while compact NFT storage options are being explored for faster data access.
CONCLUSION
NFTs offer significant potential for secure, traceable, decentralized healthcare data exchange systems. However, challenges exist, including dependence on blockchain, interoperability issues, and associated costs. The review identified research gaps, such as developing dual ownership models and data pricing strategies. Building an open standard for interoperability and adoption is crucial. The scalability, security, and privacy of NFT-backed healthcare applications require further investigation. Thus, this study proposes a research agenda for adopting NFTs in healthcare, focusing on governance, storage models, and perceptions.
PubMed: 38919876
DOI: 10.3389/fdgth.2024.1377531 -
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 -
NPJ Precision Oncology Aug 2023This study evaluates the quality of published research using artificial intelligence (AI) for ovarian cancer diagnosis or prognosis using histopathology data. A... (Review)
Review
This study evaluates the quality of published research using artificial intelligence (AI) for ovarian cancer diagnosis or prognosis using histopathology data. A systematic search of PubMed, Scopus, Web of Science, Cochrane CENTRAL, and WHO-ICTRP was conducted up to May 19, 2023. Inclusion criteria required that AI was used for prognostic or diagnostic inferences in human ovarian cancer histopathology images. Risk of bias was assessed using PROBAST. Information about each model was tabulated and summary statistics were reported. The study was registered on PROSPERO (CRD42022334730) and PRISMA 2020 reporting guidelines were followed. Searches identified 1573 records, of which 45 were eligible for inclusion. These studies contained 80 models of interest, including 37 diagnostic models, 22 prognostic models, and 21 other diagnostically relevant models. Common tasks included treatment response prediction (11/80), malignancy status classification (10/80), stain quantification (9/80), and histological subtyping (7/80). Models were developed using 1-1375 histopathology slides from 1-776 ovarian cancer patients. A high or unclear risk of bias was found in all studies, most frequently due to limited analysis and incomplete reporting regarding participant recruitment. Limited research has been conducted on the application of AI to histopathology images for diagnostic or prognostic purposes in ovarian cancer, and none of the models have been demonstrated to be ready for real-world implementation. Key aspects to accelerate clinical translation include transparent and comprehensive reporting of data provenance and modelling approaches, and improved quantitative evaluation using cross-validation and external validations. This work was funded by the Engineering and Physical Sciences Research Council.
PubMed: 37653025
DOI: 10.1038/s41698-023-00432-6 -
Foods (Basel, Switzerland) Aug 2023With the rise of globalization and technological competition, the food supply chain has grown more complex due to the multiple players and factors involved in the chain.... (Review)
Review
With the rise of globalization and technological competition, the food supply chain has grown more complex due to the multiple players and factors involved in the chain. Traditional systems fail to offer effective and reliable traceability solutions considering the increasing requirement for accountability and transparency in the food supply chain. Blockchain technology has been claimed to offer the food industry a transformative future. The inherent features of blockchain, including immutability and transparency, create a dependable and secure system for tracking food products across the whole supply chain, ensuring total control over their traceability from the origin to the final consumer. This research offers a comprehensive overview of multiple models to understand how the integration of blockchain and other digital technologies has transformed the food supply chain. This comprehensive systematic review of blockchain-based food-supply-chain frameworks aimed to uncover the capability of blockchain technology to revolutionize the industry and examined the current landscape of blockchain-based food traceability solutions to identify areas for improvement. Furthermore, the research investigates recent advancements and investigates how blockchain aligns with other emerging technologies of Industry 4.0 and Web 3.0. Blockchain technology plays an important role in improving food traceability and supply-chain operations. Potential synergies between blockchain and other emerging technologies of Industry 4.0 and Web 3.0 are digitizing food supply chains, which results in better management, automation, efficiencies, sustainability, verifiability, auditability, accountability, traceability, transparency, tracking, monitoring, response times and provenance across food supply chains.
PubMed: 37628025
DOI: 10.3390/foods12163026 -
Sensors (Basel, Switzerland) Jul 2023Data provenance means recording data origins and the history of data generation and processing. In healthcare, data provenance is one of the essential processes that... (Review)
Review
Data provenance means recording data origins and the history of data generation and processing. In healthcare, data provenance is one of the essential processes that make it possible to track the sources and reasons behind any problem with a user's data. With the emergence of the General Data Protection Regulation (GDPR), data provenance in healthcare systems should be implemented to give users more control over data. This SLR studies the impacts of data provenance in healthcare and GDPR-compliance-based data provenance through a systematic review of peer-reviewed articles. The SLR discusses the technologies used to achieve data provenance and various methodologies to achieve data provenance. We then explore different technologies that are applied in the healthcare domain and how they achieve data provenance. In the end, we have identified key research gaps followed by future research directions.
Topics: Biomedical Research; Delivery of Health Care
PubMed: 37514788
DOI: 10.3390/s23146495 -
Journal of Personalized Medicine Jun 2023This article aims to perform a Systematic Literature Review (SLR) to better understand the structures of different methods, techniques, models, methodologies, and... (Review)
Review
AIMS
This article aims to perform a Systematic Literature Review (SLR) to better understand the structures of different methods, techniques, models, methodologies, and technologies related to provenance data management in health information systems (HISs). The SLR developed here seeks to answer the questions that contribute to describing the results.
METHOD
An SLR was performed on six databases using a search string. The backward and forward snowballing technique was also used. Eligible studies were all articles in English that presented on the use of different methods, techniques, models, methodologies, and technologies related to provenance data management in HISs. The quality of the included articles was assessed to obtain a better connection to the topic studied.
RESULTS
Of the 239 studies retrieved, 14 met the inclusion criteria described in this SLR. In order to complement the retrieved studies, 3 studies were included using the backward and forward snowballing technique, totaling 17 studies dedicated to the construction of this research. Most of the selected studies were published as conference papers, which is common when involving computer science in HISs. There was a more frequent use of data provenance models from the PROV family in different HISs combined with different technologies, among which blockchain and middleware stand out. Despite the advantages found, the lack of technological structure, data interoperability problems, and the technical unpreparedness of working professionals are still challenges encountered in the management of provenance data in HISs.
CONCLUSION
It was possible to conclude the existence of different methods, techniques, models, and combined technologies, which are presented in the proposal of a taxonomy that provides researchers with a new understanding about the management of provenance data in HISs.
PubMed: 37373980
DOI: 10.3390/jpm13060991 -
European Respiratory Review : An... Jun 2023COPD and adult-onset asthma (AOA) are the most common noncommunicable respiratory diseases. To improve early identification and prevention, an overview of risk factors... (Review)
Review
BACKGROUND
COPD and adult-onset asthma (AOA) are the most common noncommunicable respiratory diseases. To improve early identification and prevention, an overview of risk factors is needed. We therefore aimed to systematically summarise the nongenetic (exposome) risk factors for AOA and COPD. Additionally, we aimed to compare the risk factors for COPD and AOA.
METHODS
In this umbrella review, we searched PubMed for articles from inception until 1 February 2023 and screened the references of relevant articles. We included systematic reviews and meta-analyses of observational epidemiological studies in humans that assessed a minimum of one lifestyle or environmental risk factor for AOA or COPD.
RESULTS
In total, 75 reviews were included, of which 45 focused on risk factors for COPD, 28 on AOA and two examined both. For asthma, 43 different risk factors were identified while 45 were identified for COPD. For AOA, smoking, a high body mass index (BMI), wood dust exposure and residential chemical exposures, such as formaldehyde exposure or exposure to volatile organic compounds, were amongst the risk factors found. For COPD, smoking, ambient air pollution including nitrogen dioxide, a low BMI, indoor biomass burning, childhood asthma, occupational dust exposure and diet were amongst the risk factors found.
CONCLUSIONS
Many different factors for COPD and asthma have been found, highlighting the differences and similarities. The results of this systematic review can be used to target and identify people at high risk for COPD or AOA.
Topics: Adult; Humans; Child; Pulmonary Disease, Chronic Obstructive; Asthma; Risk Factors; Air Pollution; Dust; Environmental Exposure
PubMed: 37137510
DOI: 10.1183/16000617.0009-2023 -
European Respiratory Review : An... Sep 2022There is growing interest in a "treatable traits" approach to pulmonary rehabilitation in chronic airways disease. The frequency with which pulmonary rehabilitation... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
There is growing interest in a "treatable traits" approach to pulmonary rehabilitation in chronic airways disease. The frequency with which pulmonary rehabilitation programmes address treatable traits is unknown.
METHODS
Randomised controlled trials of pulmonary rehabilitation compared to usual care in patients with stable chronic airways disease were included. The components of pulmonary rehabilitation delivered were extracted and mapped to treatable traits in pulmonary, extrapulmonary and behavioural/lifestyle domains. Meta-analysis was used to evaluate the impact of addressing >1 treatable trait on exercise capacity and health-related quality of life (HRQoL).
RESULTS
116 trials were included (6893 participants). Almost all pulmonary rehabilitation programmes addressed deconditioning (97% of trials). The most commonly addressed extrapulmonary traits were nutritional status (obesity and cachexia, 18% each) and mood disturbance (anxiety and depression, 10% each). Behavioural/lifestyle traits most frequently addressed were nonadherence (46%), poor inhalation technique (24%) and poor family/social support (19%). Exercise capacity and HRQoL outcomes did not differ between studies that addressed deconditioning alone and those that targeted additional traits, but heterogeneity was high.
CONCLUSION
Aside from deconditioning, treatable traits are infrequently addressed in existing trials of pulmonary rehabilitation. The potential of the treatable traits approach to improve pulmonary rehabilitation outcomes remains to be explored.
Topics: Humans; Phenotype; Pulmonary Disease, Chronic Obstructive; Quality of Life
PubMed: 36002168
DOI: 10.1183/16000617.0042-2022 -
Journal of Medical Internet Research May 2021Digital health technologies (DHTs) generate a large volume of information used in health care for administrative, educational, research, and clinical purposes. The... (Review)
Review
BACKGROUND
Digital health technologies (DHTs) generate a large volume of information used in health care for administrative, educational, research, and clinical purposes. The clinical use of digital information for diagnostic, therapeutic, and prognostic purposes has multiple patient safety problems, some of which result from poor information quality (IQ).
OBJECTIVE
This systematic review aims to synthesize an IQ framework that could be used to evaluate the extent to which digital health information is fit for clinical purposes.
METHODS
The review was conducted according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) guidelines. We searched Embase, MEDLINE, PubMed, CINAHL, Maternity and Infant Care, PsycINFO, Global Health, ProQuest Dissertations and Theses Global, Scopus, and HMIC (the Health Management Information Consortium) from inception until October 2019. Multidimensional IQ frameworks for assessing DHTs used in the clinical context by health care professionals were included. A thematic synthesis approach was used to synthesize the Clinical Information Quality (CLIQ) framework for digital health.
RESULTS
We identified 10 existing IQ frameworks from which we developed the CLIQ framework for digital health with 13 unique dimensions: accessibility, completeness, portability, security, timeliness, accuracy, interpretability, plausibility, provenance, relevance, conformance, consistency, and maintainability, which were categorized into 3 meaningful categories: availability, informativeness, and usability.
CONCLUSIONS
This systematic review highlights the importance of the IQ of DHTs and its relevance to patient safety. The CLIQ framework for digital health will be useful in evaluating and conceptualizing IQ issues associated with digital health, thus forestalling potential patient safety problems.
TRIAL REGISTRATION
PROSPERO International Prospective Register of Systematic Reviews CRD42018097142; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=97142.
INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)
RR2-10.1136/bmjopen-2018-024722.
Topics: Delivery of Health Care; Female; Humans; Pregnancy
PubMed: 33835034
DOI: 10.2196/23479 -
Clinical Kidney Journal Feb 2021Respiratory tract infections (RTIs) are a common reason for people to seek medical care. RTIs are associated with high short-term mortality. Inconsistent evidence exists...
BACKGROUND
Respiratory tract infections (RTIs) are a common reason for people to seek medical care. RTIs are associated with high short-term mortality. Inconsistent evidence exists in the association between the presence of kidney disease and the risk of death in patient with RTIs.
METHODS
We searched the PubMed, Cochrane Library and Embase databases from inception through April 2019 for cohort and case-control studies investigating the presence of kidney disease (defined as medical diagnosis of kidney disease, reduced estimated glomerular filtration rate or creatinine clearance, elevated serum creatinine and proteinuria) on mortality in adults with RTIs in different settings including community, inpatient and intensive care units. We assessed the quality of the included studies using Cochrane Collaboration's tool and conducted a meta-analysis on the relative risk (RR) of death.
RESULTS
Of 5362 records identified, 18 studies involving 16 676 participants met the inclusion criteria, with 15 studies investigating pneumonia and 3 studies exploring influenza. The risk of bias in the available evidence was moderate. Most [17/18 (94.5%)] of studies reported positive associations of underlying chronic kidney disease with mortality. The pooled adjusted risk for all-cause mortality in patients with RTIs almost doubled [RR 1.96 (95% confidence interval 1.48-2.59)] in patients with kidney disease. Associations were consistent across different timings of kidney disease assessment and provenances of RTIs (community-acquired or healthcare-associated).
CONCLUSIONS
The presence of kidney disease is associated with higher mortality among people with RTIs, especially in those with pneumonia. The presence of kidney disease might be taken into account when considering admission for patients who present with RTIs.
PubMed: 33623685
DOI: 10.1093/ckj/sfz188