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Frontiers in Digital Health 2021The analysis of clinical free text from patient records for research has potential to contribute to the medical evidence base but access to clinical free text is...
The analysis of clinical free text from patient records for research has potential to contribute to the medical evidence base but access to clinical free text is frequently denied by data custodians who perceive that the privacy risks of data-sharing are too high. Engagement activities with patients and regulators, where views on the sharing of clinical free text data for research have been discussed, have identified that stakeholders would like to understand the potential clinical benefits that could be achieved if access to free text for clinical research were improved. We aimed to systematically review all UK research studies which used clinical free text and report direct or potential benefits to patients, synthesizing possible benefits into an easy to communicate taxonomy for public engagement and policy discussions. We conducted a systematic search for articles which reported primary research using clinical free text, drawn from UK health record databases, which reported a benefit or potential benefit for patients, actionable in a clinical environment or health service, and not solely methods development or data quality improvement. We screened eligible papers and thematically analyzed information about clinical benefits reported in the paper to create a taxonomy of benefits. We identified 43 papers and derived five themes of benefits: health-care quality or services improvement, observational risk factor-outcome research, drug prescribing safety, case-finding for clinical trials, and development of clinical decision support. Five papers compared study quality with and without free text and found an improvement of accuracy when free text was included in analytical models. Findings will help stakeholders weigh the potential benefits of free text research against perceived risks to patient privacy. The taxonomy can be used to aid public and policy discussions, and identified studies could form a public-facing repository which will help the health-care text analysis research community better communicate the impact of their work.
PubMed: 34713089
DOI: 10.3389/fdgth.2021.606599 -
Journal of Cloud Computing (Heidelberg,... 2022The fog computing concept was proposed to help cloud computing for the data processing of Internet of Things (IoT) applications. However, fog computing faces several... (Review)
Review
The fog computing concept was proposed to help cloud computing for the data processing of Internet of Things (IoT) applications. However, fog computing faces several challenges such as security, privacy, and storage. One way to address these challenges is to integrate blockchain with fog computing. There are several applications of blockchain-fog computing integration that have been proposed, recently, due to their lucrative benefits such as enhancing security and privacy. There is a need to systematically review and synthesize the literature on this topic of blockchain-fog computing integration. The purposes of integrating blockchain and fog computing were determined using a systematic literature review approach and tailored search criteria established from the research questions. In this research, 181 relevant papers were found and reviewed. The results showed that the authors proposed the combination of blockchain and fog computing for several purposes such as security, privacy, access control, and trust management. A lack of standards and laws may make it difficult for blockchain and fog computing to be integrated in the future, particularly in light of newly developed technologies like quantum computing and artificial intelligence. The findings of this paper serve as a resource for researchers and practitioners of blockchain-fog computing integration for future research and designs.
PubMed: 36438442
DOI: 10.1186/s13677-022-00353-y -
HERD Jan 2023To provide a live-experience knowledge base about biophilic design parameters and environmental features to inform policy and design in clinical therapeutic environments. (Review)
Review
OBJECTIVES
To provide a live-experience knowledge base about biophilic design parameters and environmental features to inform policy and design in clinical therapeutic environments.
BACKGROUND
It is increasingly important to review hospital design to make the best use of the affordances of natural elements in supporting both patients' and staff's physical and psychological well-being. The biophilic design theory provides an appropriate design approach. However, current biophilic design frameworks fail to provide efficiently standardized guidance. This systematic review aims to examine the experience of hospital users (patients and staff) with a view to informing a standardized biophilic design framework to improve future design in this context.
METHODS
This study performed a review and synthesis of nine studies identified using systematic procedures focusing on biophilic design features in healthcare environments.
RESULTS
The study identified a selection of biophilic parameters specifically relevant to this building typology, according to three different user groups: outpatients (fresh air, light-daylight, thermal comfort, welcoming and relaxing), inpatients (feeling relaxed and comfortable, prospect refuge, security and protection, light-daylight, view), and staff (privacy-refuge, quietness).
CONCLUSIONS
The systematically identified studies helped to identify and rank the biophilic design parameters that appear the most critical for promoting and supporting human health and well-being in clinical therapeutic environments from the user's perspective. It also provides an up-to-date compilation of crucial design interventions related to biophilic parameters and as such provides benchmark information for future research and design guidance in these environments.
PubMed: 35996349
DOI: 10.1177/19375867221118675 -
Journal of Medical Internet Research Nov 2023The COVID-19 pandemic necessitated rapid changes to health care delivery, including a shift from in-person to digitally delivered psychotherapy. While these changes... (Review)
Review
BACKGROUND
The COVID-19 pandemic necessitated rapid changes to health care delivery, including a shift from in-person to digitally delivered psychotherapy. While these changes helped ensure timely psychotherapy provision, many concerns exist, including clinical, cultural, practical, privacy, and security issues.
OBJECTIVE
This scoping review systematically mapped existing peer-reviewed research on synchronous, therapist-delivered web-based psychotherapy for individuals with a diagnosed mental illness. Data were analyzed through the lens of the Alberta Quality Matrix for Health (AQMH) to assess to what degree this literature addresses key indicators of health care quality. This analysis aided in the identification and organization of knowledge gaps with regard to web-based psychotherapies, highlighting potential disparities between previously prioritized dimensions of care and those requiring further attention.
METHODS
This review adhered to the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) guidelines. We included peer-reviewed primary research studies in the English language investigating synchronous, therapist-delivered remote psychotherapy delivered to adults (aged 18 years and older) with a Diagnostic and Statistical Manual of Mental Disorders or International Statistical Classification of Diseases diagnosed mental illness. All other citations were excluded. Relevant studies were identified through MEDLINE, APA PsycINFO, Embase (OVID), Web of Science: Core Collection (Clarivate), Cochrane Library (Wiley), and Scopus (Elsevier) databases. Databases were searched on March 18, 2021. For every publication that was taken into consideration, the data were charted independently by 2 reviewers, and in the event of a discrepancy, the principal investigator validated the choice of either extractor. Results were thematically described according to the 6 AQMH dimensions: acceptability, accessibility, appropriateness, effectiveness, efficiency, and safety.
RESULTS
From 13,209 publications, 48 articles were included, largely from North American studies. Most studies measured treatment effectiveness (n=48, 100%) and acceptability (n=29, 60%) health quality dimensions. Over 80% (40/48) of studies investigated either a cognitive or exposure intervention for either posttraumatic stress disorder or a mood or anxiety disorder, generally indicating comparable results to in-person therapy. Safety (n=5, 10%) was measured in fewer studies, while treatment accessibility, appropriateness, and efficiency were not explicitly measured in any study, although these dimensions were mentioned as a future direction, hypothesis, or potential outcome.
CONCLUSIONS
In relation to web-based therapist-delivered psychotherapies for those with a diagnosed mental illness, important aspects of health care quality (accessibility, appropriateness, efficiency, and safety) have received little scientific examination, underscoring a need to address these gaps. There are also significant issues related to the generalizability of this literature, including the underrepresentation of many geographic regions, cultures, populations, clinical contexts, and psychotherapy modalities. Qualitative research in underrepresented populations and settings may uncover important patient and contextual factors important for the future implementation of quality web-based psychotherapy.
Topics: Adult; Humans; Pandemics; Psychotherapy; Anxiety Disorders; Stress Disorders, Post-Traumatic; Internet
PubMed: 37921863
DOI: 10.2196/40710 -
Travel Medicine and Infectious Disease 2021The advent of mobile applications for health and medicine will revolutionize travel medicine. Despite their many benefits, such as access to real-time data, mobile apps... (Review)
Review
BACKGROUND
The advent of mobile applications for health and medicine will revolutionize travel medicine. Despite their many benefits, such as access to real-time data, mobile apps for travel medicine are accompanied by many ethical issues, including questions about security and privacy.
METHODS
A systematic literature review as conducted following PRISMA guidelines. Database screening yielded 1795 results and seven papers satisfied the criteria for inclusion. Through a mix of inductive and deductive data extraction, this systematic review examined both the benefits and challenges, as well as ethical considerations, of mobile apps for travel medicine.
RESULTS
Ethical considerations were discussed with varying depth across the included articles, with privacy and data protection mentioned most frequently, highlighting concerns over sensitive information and a lack of guidelines in the digital sphere. Additionally, technical concerns about data quality and bias were predominant issues for researchers and developers alike. Some ethical issues were not discussed at all, including equity, and user involvement.
CONCLUSION
This paper highlights the scarcity of discussion around ethical issues. Both researchers and developers need to better integrate ethical reflection at each step of the development and use of health apps. More effective oversight mechanisms and clearer ethical guidance are needed to guide the stakeholders in this endeavour.
Topics: Humans; Mobile Applications; Privacy; Travel Medicine
PubMed: 34256131
DOI: 10.1016/j.tmaid.2021.102143 -
Computational Intelligence and... 2022Cloud computing is a long-standing dream of computing as a utility, where users can store their data remotely in the cloud to enjoy on-demand services and high-quality... (Review)
Review
Cloud computing is a long-standing dream of computing as a utility, where users can store their data remotely in the cloud to enjoy on-demand services and high-quality applications from a shared pool of configurable computing resources. Thus, the privacy and security of data are of utmost importance to all of its users regardless of the nature of the data being stored. In cloud computing environments, it is especially critical because data is stored in various locations, even around the world, and users do not have any physical access to their sensitive data. Therefore, we need certain data protection techniques to protect the sensitive data that is outsourced over the cloud. In this paper, we conduct a systematic literature review (SLR) to illustrate all the data protection techniques that protect sensitive data outsourced over cloud storage. Therefore, the main objective of this research is to synthesize, classify, and identify important studies in the field of study. Accordingly, an evidence-based approach is used in this study. Preliminary results are based on answers to four research questions. Out of 493 research articles, 52 studies were selected. 52 papers use different data protection techniques, which can be divided into two main categories, namely noncryptographic techniques and cryptographic techniques. Noncryptographic techniques consist of data splitting, data anonymization, and steganographic techniques, whereas cryptographic techniques consist of encryption, searchable encryption, homomorphic encryption, and signcryption. In this work, we compare all of these techniques in terms of data protection accuracy, overhead, and operations on masked data. Finally, we discuss the future research challenges facing the implementation of these techniques.
Topics: Cloud Computing; Computer Security; Confidentiality; Delivery of Health Care; Privacy
PubMed: 35712069
DOI: 10.1155/2022/8303504 -
Journal of Medical Internet Research Dec 2023Chatbots have become ubiquitous in our daily lives, enabling natural language conversations with users through various modes of communication. Chatbots have the... (Review)
Review
BACKGROUND
Chatbots have become ubiquitous in our daily lives, enabling natural language conversations with users through various modes of communication. Chatbots have the potential to play a significant role in promoting health and well-being. As the number of studies and available products related to chatbots continues to rise, there is a critical need to assess product features to enhance the design of chatbots that effectively promote health and behavioral change.
OBJECTIVE
This scoping review aims to provide a comprehensive assessment of the current state of health-related chatbots, including the chatbots' characteristics and features, user backgrounds, communication models, relational building capacity, personalization, interaction, responses to suicidal thoughts, and users' in-app experiences during chatbot use. Through this analysis, we seek to identify gaps in the current research, guide future directions, and enhance the design of health-focused chatbots.
METHODS
Following the scoping review methodology by Arksey and O'Malley and guided by the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) checklist, this study used a two-pronged approach to identify relevant chatbots: (1) searching the iOS and Android App Stores and (2) reviewing scientific literature through a search strategy designed by a librarian. Overall, 36 chatbots were selected based on predefined criteria from both sources. These chatbots were systematically evaluated using a comprehensive framework developed for this study, including chatbot characteristics, user backgrounds, building relational capacity, personalization, interaction models, responses to critical situations, and user experiences. Ten coauthors were responsible for downloading and testing the chatbots, coding their features, and evaluating their performance in simulated conversations. The testing of all chatbot apps was limited to their free-to-use features.
RESULTS
This review provides an overview of the diversity of health-related chatbots, encompassing categories such as mental health support, physical activity promotion, and behavior change interventions. Chatbots use text, animations, speech, images, and emojis for communication. The findings highlight variations in conversational capabilities, including empathy, humor, and personalization. Notably, concerns regarding safety, particularly in addressing suicidal thoughts, were evident. Approximately 44% (16/36) of the chatbots effectively addressed suicidal thoughts. User experiences and behavioral outcomes demonstrated the potential of chatbots in health interventions, but evidence remains limited.
CONCLUSIONS
This scoping review underscores the significance of chatbots in health-related applications and offers insights into their features, functionalities, and user experiences. This study contributes to advancing the understanding of chatbots' role in digital health interventions, thus paving the way for more effective and user-centric health promotion strategies. This study informs future research directions, emphasizing the need for rigorous randomized control trials, standardized evaluation metrics, and user-centered design to unlock the full potential of chatbots in enhancing health and well-being. Future research should focus on addressing limitations, exploring real-world user experiences, and implementing robust data security and privacy measures.
Topics: Humans; Digital Health; Health Promotion; Communication; Benchmarking; Checklist; Randomized Controlled Trials as Topic
PubMed: 38113097
DOI: 10.2196/47217 -
PeerJ. Computer Science 2022Microservices is an emerging paradigm for developing distributed systems. With their widespread adoption, more and more work investigated the relation between...
Microservices is an emerging paradigm for developing distributed systems. With their widespread adoption, more and more work investigated the relation between microservices and security. Alas, the literature on this subject does not form a well-defined : it is spread over many venues and composed of contributions mainly addressing specific scenarios or needs. In this work, we conduct a systematic review of the field, gathering 290 relevant publications-at the time of writing, the largest curated dataset on the topic. We analyse our dataset along two lines: (a) quantitatively, through publication metadata, which allows us to chart publication outlets, communities, approaches, and tackled issues; (b) qualitatively, through 20 research questions used to provide an aggregated overview of the literature and to spot gaps left open. We summarise our analyses in the conclusion in the form of a call for action to address the main open challenges.
PubMed: 35111904
DOI: 10.7717/peerj-cs.779 -
Journal of Clinical Tuberculosis and... May 2024Virtual modes of tuberculosis (TB) treatment monitoring have become increasingly relevant in the last decade with the advancements and increasing accessibility of... (Review)
Review
Virtual modes of tuberculosis (TB) treatment monitoring have become increasingly relevant in the last decade with the advancements and increasing accessibility of technology. We conducted a systematic review comparing people with TB's perceptions of standard directly observed therapy (DOT) versus video directly observed therapy (vDOT). Studies were obtained from MEDLINE and EMBASE between January 1, 1974 and February 4, 2021. Of the 22 articles reviewed, a qualitative thematic analysis was performed, drawing on common themes from people with TB's perception of their care. 21 studies showed relative preference for and acceptance of vDOT over DOT. Factors that increased acceptability toward vDOT included cost and time saving, personal sense of empowerment, convenience, and privacy. Studies also showed greater adherence to treatment and subsequent improved health outcomes. vDOT has the potential to be an empowering, person-centered treatment modality for TB therapy. The role of social determinants such as place of residence, access to technology, and patient-provider communication requires further exploration.
PubMed: 38380432
DOI: 10.1016/j.jctube.2023.100406 -
International Journal of Environmental... Feb 2023This scoping review mapped and synthesised existing evidence on the influence of individual, parental, peer, and societal-related factors on adolescents' decisions to... (Review)
Review
This scoping review mapped and synthesised existing evidence on the influence of individual, parental, peer, and societal-related factors on adolescents' decisions to use contraception in sub-Saharan Africa (SSA). Peer-reviewed and review articles published before May 2022, targeting adolescents aged 10-19 years were searched in PubMed, MEDLINE with Full Text via EBSCOhost, PsychINFO via EBSCOhost, CINAHL with Full Text via EBSCOhost, Google Scholar, Science Direct, and Scopus databases. Seven studies were included and analysed using thematic analysis based on the social-ecological model (SEM) and reported using the preferred reporting items for systematic reviews and meta-analyses (PRISMA). Individual (fear of side effects, fear of infertility), parental (parental disappointment and disapproval), peer (social stigma), partner (association with promiscuity and multiple sexual partners), societal and community (contraceptive use disapproval and stigma), and institutional and environmental factors (lack of privacy and confidentiality) influence contraceptive decisions among adolescents. These also include a lack of accurate information, social exclusion, negative health provider attitudes, and a lack of infrastructure that provides privacy and safe spaces. Identifying and addressing core issues within the context of local cultural practices that restrict contraceptive use is important. Holistic, inclusive approaches that promote the well-being of adolescents must be utilised to provide a conducive environment that ensures privacy, confidentiality, safety, and easy access to contraceptive services.
Topics: Humans; Adolescent; Contraceptive Agents; Contraception; Confidentiality; Africa South of the Sahara; Privacy
PubMed: 36768107
DOI: 10.3390/ijerph20032744