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BMC Medical Informatics and Decision... Jun 2024This study aimed to develop and validate a quantitative index system for evaluating the data quality of Electronic Medical Records (EMR) in disease risk prediction using...
OBJECTIVE
This study aimed to develop and validate a quantitative index system for evaluating the data quality of Electronic Medical Records (EMR) in disease risk prediction using Machine Learning (ML).
MATERIALS AND METHODS
The index system was developed in four steps: (1) a preliminary index system was outlined based on literature review; (2) we utilized the Delphi method to structure the indicators at all levels; (3) the weights of these indicators were determined using the Analytic Hierarchy Process (AHP) method; and (4) the developed index system was empirically validated using real-world EMR data in a ML-based disease risk prediction task.
RESULTS
The synthesis of review findings and the expert consultations led to the formulation of a three-level index system with four first-level, 11 second-level, and 33 third-level indicators. The weights of these indicators were obtained through the AHP method. Results from the empirical analysis illustrated a positive relationship between the scores assigned by the proposed index system and the predictive performances of the datasets.
DISCUSSION
The proposed index system for evaluating EMR data quality is grounded in extensive literature analysis and expert consultation. Moreover, the system's high reliability and suitability has been affirmed through empirical validation.
CONCLUSION
The novel index system offers a robust framework for assessing the quality and suitability of EMR data in ML-based disease risk predictions. It can serve as a guide in building EMR databases, improving EMR data quality control, and generating reliable real-world evidence.
Topics: Electronic Health Records; Humans; Machine Learning; Data Accuracy; Risk Assessment; Delphi Technique
PubMed: 38915008
DOI: 10.1186/s12911-024-02533-z -
Scientific Reports Jun 2024Psoriasis is a chronic skin disease that negatively impacts on patient's life. A holistic approach integrating well-being assessment could improve disease management....
Psoriasis is a chronic skin disease that negatively impacts on patient's life. A holistic approach integrating well-being assessment could improve disease management. Since a consensus definition of well-being in psoriasis is not available, we aim to achieve a multidisciplinary consensus on well-being definition and its components. A literature review and consultation with psoriasis patients facilitated the design of a two-round Delphi questionnaire targeting healthcare professionals and psoriasis patients. A total of 261 panellists (65.1% patients with psoriasis, 34.9% healthcare professionals) agreed on the dimensions and components that should integrate the concept of well-being: emotional dimension (78.9%) [stress (83.9%), mood disturbance (85.1%), body image (83.9%), stigma/shame (75.1%), self-esteem (77.4%) and coping/resilience (81.2%)], physical dimension (82.0%) [sleep quality (81.6%), pain/discomfort (80.8%), itching (83.5%), extracutaneous manifestations (82.8%), lesions in visible areas (84.3%), lesions in functional areas (85.8%), and sex life (78.2%)], social dimension (79.5%) [social relationships (80.8%), leisure/recreational activities (80.3%), support from family/friends (76.6%) and work/academic life (76.5%)], and satisfaction with disease management (78.5%) [treatment (78.2%), information received (75.6%) and medical care provided by the dermatologist (80.1%)]. This well-being definition reflects patients' needs and concerns. Therefore, addressing them in psoriasis will optimise management, contributing to better outcomes and restoring normalcy to the patient's life.
Topics: Humans; Psoriasis; Health Personnel; Delphi Technique; Female; Male; Surveys and Questionnaires; Consensus; Adult; Quality of Life; Middle Aged; Self Concept
PubMed: 38914574
DOI: 10.1038/s41598-024-64738-6 -
Revista Brasileira de Ortopedia Jun 2024This study aimed to describe the methodological process for developing a questionnaire to identify the prevalence and risk factors for chronic occupational low back...
This study aimed to describe the methodological process for developing a questionnaire to identify the prevalence and risk factors for chronic occupational low back pain in healthcare professionals working at hospitals. An exploratory crossectional survey study was carried out in Belo Horizonte, MG, Brazil, and its metropolitan region, in two stages. Initially, the authors prepared a questionnaire based on the Roland Morris disability questionnaire and sent it to a committee of low back pain specialists for validation using the Delphi technique. The second stage consisted of sending the final questionnaire to health professionals working in a hospital environment for at least 2 years and presenting chronic low back pain for at least 3 months. Validation occurred in two rounds of questionnaire adjustments by a panel consisting of physical therapists and physician experts in the field (orthopedists with more than 3 years of experience). Both rounds had 13 participants. The questionnaire initially consisted of 27 items, and, after validation, it had 19 items. The study included 65 subjects, with an average age of 40.91 years old and an average time working at a hospital of 40 hours per week. The total sample had 76.9% of physicians, 10.8% of physical therapists, and 12.3% of nurses or nursing technicians. Most (52.3%) subjects reported staying in uncomfortable positions affecting the lower back for 5 to 10 hours per day. We developed and validated, using the Delphi technique, a questionnaire on the prevalence and risk factors associated with chronic occupational low back pain among healthcare professionals working at hospitals. This unprecedented tool can benefit the population studied since the questionnaires currently used to evaluate chronic low back pain are not specific for investigating the occupational cause of this condition.
PubMed: 38911888
DOI: 10.1055/s-0044-1786729 -
Journal of Hand Surgery Global Online Mar 2024The aim of this study was to establish the consensus recommendations among hand surgeons who were experts in the use of collagenase clostridium histolyticum (CCH) on the...
PURPOSE
The aim of this study was to establish the consensus recommendations among hand surgeons who were experts in the use of collagenase clostridium histolyticum (CCH) on the appropriate treatment of Dupuytren disease in well-defined patient populations with varying degrees of disease severity and functional impairment.
METHODS
A three-round, blinded, modified Delphi process examined panelists' approaches to CCH treatment of metacarpophalangeal (MP) or proximal interphalangeal (PIP) joint contractures involving one or two fingers with varying degrees of severity. Clinical scenarios related to poor-quality skin, postfasciectomy scarring, boutonnière deformity, closed capsulotomy, and blood thinner use were also presented for panelist consideration. Panelists provided responses to clinical scenarios using a 5-point Likert scale or a yes/no response. Consensus was defined as ≥66.7% panelist agreement or disagreement.
RESULTS
Twenty panelists completed round 1; 19 of the 20 panelists completed rounds 2 and 3. Panelists achieved a high level of consensus for using CCH for the treatment of patients with palpable cords and varying severity contractures representing one- or two-finger MP joint contractures, most one- or two-finger PIP joint contractures, and most combined MP and PIP joint contractures. Consensus for the treatment of PIP joint contractures was mostly achieved, but clinical scenarios related to recurrent PIP contracture with poor-quality skin and/or significant postfasciectomy scarring, boutonnière deformity, PIP contractures >70°, closed capsulotomy, and blood thinner use were modified, and then most (95.3%) statements reached consensus for agreement in round 2. In round 3, open-ended responses indicated that panelists considered CCH appropriate for most patients with Dupuytren disease.
CONCLUSIONS
Consensus-based findings among expert hand surgeons with substantial CCH experience indicated that CCH has a wide-ranging application for the treatment of Dupuytren disease in patients with varying degrees of disease severity and functional impairment.
TYPE OF STUDY/LEVEL OF EVIDENCE
Therapeutic V.
PubMed: 38903838
DOI: 10.1016/j.jhsg.2023.10.011 -
BMC Primary Care Jun 2024Primary Health Care (PHC) plays a crucial role in managing the COVID-19 pandemic, with only 8% of cases requiring hospitalization. However, PHC COVID-19 data often goes...
BACKGROUND
Primary Health Care (PHC) plays a crucial role in managing the COVID-19 pandemic, with only 8% of cases requiring hospitalization. However, PHC COVID-19 data often goes unnoticed on European government dashboards and in media discussions. This project aims to examine official information on PHC patient care during the COVID-19 pandemic in Europe, with specific objectives: (1) Describe PHC's clinical pathways for acute COVID-19 cases, including long-term care facilities, (2) Describe PHC COVID-19 pandemic indicators, (3) Develop COVID-19 PHC activity indicators, (4) Explain PHC's role in vaccination strategies, and (5) Create a PHC contingency plan for future pandemics.
METHODS
A mixed-method study will employ two online questionnaires to gather retrospective PHC data on COVID-19 management and PHC involvement in vaccination strategies. Validation will occur through focus group discussions with medical and public health (PH) experts. A two-wave Delphi survey will establish a European PHC indicators dashboard for future pandemics. Additionally, a coordinated health system action plan involving PHC, secondary care, and PH will be devised to address future pandemic scenarios.
ANALYSIS
Quantitative data will be analysed using STATA v16.0 for descriptive and multivariate analyses. Qualitative data will be collected through peer-reviewed questionnaires and content analysis of focus group discussions. A Delphi survey and multiple focus groups will be employed to achieve consensus on PHC indicators and a common European health system response plan for future pandemics. The Eurodata research group involving researchers from 28 European countries support the development.
DISCUSSION
While PHC manages most COVID-19 acute cases, data remains limited in many European countries. This study collects data from numerous countries, offering a comprehensive perspective on PHC's role during the pandemic in Europe. It pioneers the development of a PHC dashboard and health system plan for pandemics in Europe. These results may prove invaluable in future pandemics. However, data may have biases due to key informants' involvement and may not fully represent all European GP practices. PHC has a significant role in the management of the COVID-19 pandemic, as most of the cases are mild or moderate and only 8% needed hospitalization. However, PHC COVID-19 activity data is invisible on governments' daily dashboards in Europe, often overlooked in media and public debates.
Topics: COVID-19; Humans; Europe; Primary Health Care; Pandemics; Surveys and Questionnaires; SARS-CoV-2; Delphi Technique; Retrospective Studies
PubMed: 38902681
DOI: 10.1186/s12875-024-02413-5 -
JAMA Network Open Jun 2024There has been an emerging trend of podcast use in medical education over the past decade. With the increasing number of podcasts and learners' interest in trauma...
IMPORTANCE
There has been an emerging trend of podcast use in medical education over the past decade. With the increasing number of podcasts and learners' interest in trauma surgery, it is vital to validate the quality of these podcasts.
OBJECTIVE
To determine the quantity and quality of podcast episodes on trauma surgery.
DESIGN, SETTING, AND PARTICIPANTS
This cross-sectional study identified trauma surgery podcasts published globally on the Google, Apple, and Spotify platforms as of May 31, 2023. An initial screening excluded podcasts not fulfilling the inclusion criteria (published as of May 31, 2023, and covering clinical knowledge or mentorship on general trauma surgery). A 10-item checklist developed from a modified Delphi consensus method was created to assess the podcasts' credibility, content, and design as indicators of quality. Data extracted from each podcast episode included the duration, setting, host and guest credentials, and fulfillment of quality indicators. Data were analyzed on August 13, 2023.
MAIN OUTCOMES AND MEASURES
The quality of each podcast was assessed using the 10-question checklist. A score of at least 80% in credibility (4 of 5 points), 75% in content (3 of 4 points), and 100% in design (1 of 1 point) was required to classify a podcast episode as having good quality.
RESULTS
The initial search identified 204 podcasts on trauma surgery, of which 55 podcasts met the inclusion criteria. All 55 podcasts were published after 2014, with the majority hosted by males (85% [61 of 72 hosts]), based in the US (91% [50 of 55 podcasts]), and focused on clinical knowledge (80% [44 of 55 podcasts]). Podcast hosts and guests predominantly held a Doctor of Medicine degree (83% [113 of 136]), with 72% [46 of 64] of guests identifying as practicing trauma surgeons. While all 55 podcasts had excellent quality in terms of content and design, 20% (11 of 55) of podcasts were rated poorly on credibility. Credibility was further reduced for 60% (33 of 55) of podcasts because of nondisclosure of conflicts of interest.
CONCLUSIONS AND RELEVANCE
In this cross-sectional study of trauma surgery podcasts, most had good-quality content and design, but there was a lack of explicit conflict of interest disclosure. Content producers need to disclose their conflicts of interest appropriately to ensure credibility and improve the quality of their podcasts.
Topics: Humans; Cross-Sectional Studies; Webcasts as Topic; Traumatology; Delphi Technique; Acute Care Surgery
PubMed: 38900427
DOI: 10.1001/jamanetworkopen.2024.15636 -
Ciencia & Saude Coletiva Jun 2024This study aims to report on the development and validation of digital educational materials based on the dimensions of home cooking skills (HCS) assessed on a scale...
This study aims to report on the development and validation of digital educational materials based on the dimensions of home cooking skills (HCS) assessed on a scale destined for PHC professionals, following the recommendations of The Dietary Guidelines for the Brazilian Population and on The Food and Nutrition Education Framework (FNE) for Public Policies. Five videos and graphic materials were developed with proposals for activities to develop HCS and encourage its implementation in actions and guidelines in the community and in professional care. The content of the materials was evaluated by experts using the Two-Round Delphi-based technique and statistical analyses for evidence of consensus. Specialists presented comments to improve the products and their applicability. The materials presented decoded language and playful illustrations with characters representative of the target population. Evidence of satisfactory content validity was presented and can be used in permanent education actions, seeking the qualification of the workforce and in FNE actions within the scope of the law. The graphic materials make it possible to associate the content of the videos with practice in contexts consistent with the reality of the individuals.
Topics: Humans; Cooking; Brazil; Health Promotion; Primary Health Care; Health Education; Delphi Technique; Nutrition Policy; Teaching Materials
PubMed: 38896665
DOI: 10.1590/1413-81232024296.02062023 -
Orphanet Journal of Rare Diseases Jun 2024Osteogenesis imperfecta (OI) is a rare disease characterized by low bone mass and bone fragility, associated with an increased risk of fractures, and skeletal and...
BACKGROUND
Osteogenesis imperfecta (OI) is a rare disease characterized by low bone mass and bone fragility, associated with an increased risk of fractures, and skeletal and extra-skeletal symptoms that results in an impairment of health-related quality of life of OI patients. Since published studies on OI in Spain are limited, this study aimed to determine the epidemiology, assessed the disease burden, management and unmet needs of OI patients in Spain. Thirty-four experts in the management of patients with osteogenesis imperfecta completed two rounds of online consultation and reported real-life experience and data from Spanish hospitals. Delphi study questionnaires were based on literature review. A working group of nationally recognized clinical experts supported the development of the study questionnaires and the final validation of results.
RESULTS
The estimated prevalence of patients diagnosed with OI in Spain is 0.56:10,000 inhabitants (95%CI: 0.54-0.59), which represents that, approximately, 2,669 OI patients are currently managed in Spanish hospitals. It is estimated that approximately 269 new patients would be diagnosed with OI each year in Spain, representing an estimated incidence of 0.06 (95%CI: 0.05-0.06) per 10,000 inhabitants per year. Clinical management of OI in Spain is performed by a range of medical specialists; however, multidisciplinary care is not fully implemented. The absence of an approved curative treatment or a treatment to reduce the clinical features of the disease remains the main unmet need.
CONCLUSIONS
This study provides a snapshot of the current situation of patients with OI in Spain reported by clinical experts. The results provide an estimation of the epidemiology of the disease, and complement the available evidence on disease burden, clinical management, and unmet needs of these patients in Spain.
Topics: Osteogenesis Imperfecta; Humans; Spain; Delphi Technique; Surveys and Questionnaires; Quality of Life; Female; Male; Prevalence
PubMed: 38890698
DOI: 10.1186/s13023-024-03248-0 -
BMJ Open Jun 2024Despite research into how to effectively implement evidence-based recommendations into clinical practice, a lack of standardisation in the commissioning and development...
BACKGROUND
Despite research into how to effectively implement evidence-based recommendations into clinical practice, a lack of standardisation in the commissioning and development of clinical practice guidelines can lead to inconsistencies and gaps in implementation. This research aimed to ascertain how topics in kidney care worthy of guideline development within the UK should be chosen, prioritised, designed and implemented.
METHODS
Following a modified Delphi methodology, a multi-disciplinary panel of experts in kidney healthcare from across the UK developed 35 statements on the issues surrounding the selection, development and implementation of nephrology guidelines. Consensus with these statements was determined by agreement using an online survey; the consensus threshold was defined as 75% agreement.
RESULTS
419 responses were received. Of the 364 healthcare practitioners (HCPs), the majority had over 20 years of experience in their role (n=123) and most respondents were nephrologists (n=95). Of the 55 non-clinical respondents, the majority were people with kidney disease (n=41) and the rest were their carers or family. Participants were from across England, Northern Ireland, Scotland and Wales. Consensus between HCPs was achieved in 32/35 statements, with 28 statements reaching ≥90% agreement. Consensus between patients and patient representatives was achieved across all 20 statements, with 13/20 reaching ≥90% agreement.
CONCLUSIONS
The current results have provided the basis for six recommendations to improve the selection, design and implementation of guidelines. Actioning these recommendations will help improve the accessibility of, and engagement with, clinical guidelines, contributing to the continuing development of best practice in UK kidney care.
Topics: Humans; Delphi Technique; United Kingdom; Consensus; Practice Guidelines as Topic; Nephrology; Surveys and Questionnaires; Kidney Diseases
PubMed: 38890135
DOI: 10.1136/bmjopen-2024-085723 -
The British Journal of Surgery Jun 2024
Defining standards and core outcomes for clinical trials in prehabilitation for colorectal surgery (DiSCO): modified Delphi methodology to achieve patient and healthcare professional consensus.
Topics: Humans; Delphi Technique; Consensus; Preoperative Exercise; Clinical Trials as Topic; Colorectal Surgery
PubMed: 38888991
DOI: 10.1093/bjs/znae056