674 results found
Meinert E, Alturkistani A, Foley KA, et al., 2019, Blockchain Implementation in Health Care: Protocol for a Systematic Review., JMIR Res Protoc, Vol: 8, ISSN: 1929-0748
BACKGROUND: A blockchain is a digitized, decentralized, distributed public ledger that acts as a shared and synchronized database that records cryptocurrency transactions. Despite the shift toward digital platforms enabled by electronic medical records, demonstrating a will to reform the health care sector, health systems face issues including security, interoperability, data fragmentation, timely access to patient data, and silos. The application of health care blockchains could enable data interoperability, enhancement of precision medicine, and reduction in prescription frauds through implementing novel methods in access and patient consent. OBJECTIVE: To summarize the evidence on the strategies and frameworks utilized to implement blockchains for patient data in health care to ensure privacy and improve interoperability and scalability. It is anticipated this review will assist in the development of recommendations that will assist key stakeholders in health care blockchain implementation, and we predict that the evidence generated will challenge the health care status quo, moving away from more traditional approaches and facilitating decision making of patients, health care providers, and researchers. METHODS: A systematic search of MEDLINE/PubMed, Embase, Scopus, ProQuest Technology Collection and Engineering Index will be conducted. Two experienced independent reviewers will conduct titles and abstract screening followed by full-text reading to determine study eligibility. Data will then be extracted onto data extraction forms before using the Cochrane Collaboration Risk of Bias Tool to appraise the quality of included randomized studies and the Risk of Bias in nonrandomized studies of Interventions to assess the quality of nonrandomized studies. Data will then be analyzed and synthesized. RESULTS: Database searches will be initiated in September 2018. We expect to complete the review in January 2019. CONCLUSIONS: This review will summarize the strategies and
Meinert E, Alturkistani A, Osama T, et al., 2019, Digital Technology in Somatic and Gene Therapy Trials of Pediatric Patients With Ocular Diseases: Protocol for a Scoping Review., JMIR Res Protoc, Vol: 8, ISSN: 1929-0748
BACKGROUND: Pharmacogenomics suggests that diseases with similar symptomatic presentations often have varying genetic causes, affecting an individual patient's response to a specific therapeutic strategy. Gene therapies and somatic cell therapies offer unique therapeutic pathways for ocular diseases and often depend on increased understanding of the genotype-phenotype relationship in disease presentation and progression. While demand for personalized medicine is increasing and the required molecular tools are available, its adoption within pediatric ophthalmology remains to be maximized in the postgenomic era. OBJECTIVE: The objective of our study was to address the individual hurdles encountered in the field of genomic-related clinical trials and facilitate the uptake of personalized medicine, we propose to conduct a review that will examine and identify the digital technologies used to facilitate data analysis in somatic and gene therapy trials in pediatric patients with ocular diseases. METHODS: This paper aims to present an outline for Healthcare Information Technology and Information and Communication Technology resources used in somatic and gene therapy clinical trials in children with ocular diseases. This review will enable authors to identify challenges and provide recommendations, facilitating the uptake of genetic and somatic therapies as therapeutic tools in pediatric ophthalmology. The review will also determine whether conducting a systematic review will be beneficial. RESULTS: Database searches will be initiated in September 2018. We expect to complete the review in December 2019. CONCLUSIONS: Based on review findings, the authors will summarize methods used for facilitating IT integration in personalized medicine. Additionally, it will identify further research gaps and determine whether conducting further reviews will be beneficial. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/10705.
Hayhoe B, Greenfield G, Majeed A, 2019, Is it getting easier to obtain antibiotics in the UK?, Br J Gen Pract, Vol: 69, Pages: 54-55
Bottle A, Kim D, Hayhoe B, et al., 2019, Frailty and comorbidity predict first hospitalisation after heart failure diagnosis in primary care: population-based observational study in England., Age Ageing
Background: frailty has only recently been recognised as important in patients with heart failure (HF), but little has been done to predict the first hospitalisation after diagnosis in unselected primary care populations. Objectives: to predict the first unplanned HF or all-cause admission after diagnosis, comparing the effects of comorbidity and frailty, the latter measured by the recently validated electronic frailty index (eFI). Design: observational study. Setting: primary care in England. Subjects: all adult patients diagnosed with HF in primary care between 2010 and 2013. Methods: we used electronic health records of patients registered with primary care practices sending records to the Clinical Practice Research Datalink (CPRD) in England with linkage to national hospital admissions and death data. Competing-risk time-to-event analyses identified predictors of first unplanned hospitalisation for HF or for any condition after diagnosis. Results: of 6,360 patients, 9% had an emergency hospitalisation for their HF, and 39% had one for any cause within a year of diagnosis; 578 (9.1%) died within a year without having any emergency admission. The main predictors of HF admission were older age, elevated serum creatinine and not being on a beta-blocker. The main predictors of all-cause admission were age, comorbidity, frailty, prior admission, not being on a beta-blocker, low haematocrit and living alone. Frailty effects were largest in patients aged under 85. Conclusions: this study suggests that frailty has predictive power beyond its comorbidity components. HF patients in the community should be assessed for frailty, which should be reflected in future HF guidelines.
James SL, Theadom A, Ellenbogen RG, et al., 2019, Global, regional, and national burden of traumatic brain injury and spinal cord injury, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016, LANCET NEUROLOGY, Vol: 18, Pages: 56-87, ISSN: 1474-4422
Chang KC-M, Vamos EP, Palladino R, et al., 2019, Impact of the NHS Health Check on inequalities in cardiovascular disease risk: a difference-in-differences matching analysis, JOURNAL OF EPIDEMIOLOGY AND COMMUNITY HEALTH, Vol: 73, Pages: 11-18, ISSN: 0143-005X
Feigin VL, Nguyen G, Cercy K, et al., 2018, Global, Regional, and Country-Specific Lifetime Risks of Stroke, 1990 and 2016, NEW ENGLAND JOURNAL OF MEDICINE, Vol: 379, Pages: 2429-2437, ISSN: 0028-4793
Foley K, Alturkistani A, Carter A, et al., MOOC Evaluation Methods: A Systematic Review Protocol, JMIR Research Protocols, ISSN: 1929-0748
Massive open online courses (MOOCs) have increased in popularity in recent years. They target a wide variety of learners and use novel teaching approaches, yet often exhibit low completion rates (10%). It is important to evaluate MOOCs to determine their impact and effectiveness, but little is known at this point about the methodologies that should be used for evaluation.
Majeed F, Protocol for a Systematic Review and Qualitative Synthesis of Information Quality Frameworks in eHealth, BMJ Open, ISSN: 2044-6055
Hayhoe B, Kim D, Aylin PP, et al., 2018, Adherence to guidelines in management of symptoms suggestive of heart failure in primary care., Heart
OBJECTIVE: Clinical guidelines on heart failure (HF) suggest timings for investigation and referral in primary care. We calculated the time for patients to achieve key elements in the recommended pathway to diagnosis of HF. METHODS: In this observational study, we used linked primary and secondary care data (Clinical Practice Research Datalink, a database of anonymised electronic records from UK general practices) between 2010 and 2013. Records were examined for presenting symptoms (breathlessness, fatigue, ankle swelling) and key elements of the National Institute for Health and Care Excellence-recommended pathway to diagnosis (serum natriuretic peptide (NP) test, echocardiography, specialist referral). RESULTS: 42 403 patients were diagnosed with HF, of whom 16 597 presented in primary care with suggestive symptoms. 6464 (39%) had recorded NP or echocardiography, and 6043 (36%) specialist referral. Median time from recorded symptom(s) to investigation (NP or echocardiography) was 292 days (IQR 34-844) and to referral 236 days (IQR 42-721). Median time from symptom(s) to diagnosis was 972 days (IQR 337-1468) and to treatment with HF-relevant medication 803 days (IQR 230-1364). Factors significantly affecting timing of referral, treatment and diagnosis included patients' sex (p=0.001), age (p<0.001), deprivation score (p=0.001), comorbidities (p<0.001) and presenting symptom type (p<0.001). CONCLUSIONS: Median times to investigation or referral of patients presenting in primary care with symptoms suggestive of HF considerably exceeded recommendations. There is a need to support clinicians in the diagnosis of HF in primary care, with improved access to investigation and specialist assessment to support timely management.
Hayhoe B, Cowling TE, Pillutla V, et al., 2018, Integrating a nationally scaled workforce of community health workers in primary care: a modelling study, JOURNAL OF THE ROYAL SOCIETY OF MEDICINE, Vol: 111, Pages: 453-461, ISSN: 0141-0768
Zunt JR, Kassebaum NJ, Blake N, et al., 2018, Global, regional, and national burden of meningitis, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016, LANCET NEUROLOGY, Vol: 17, Pages: 1061-1082, ISSN: 1474-4422
Lozano R, Fullman N, Abate D, et al., 2018, Measuring progress from 1990 to 2017 and projecting attainment to 2030 of the health-related Sustainable Development Goals for 195 countries and territories: a systematic analysis for the Global Burden of Disease Study 2017, LANCET, Vol: 392, Pages: 2091-2138, ISSN: 0140-6736
Roth GA, Collaborotors GBDCD, Abate D, et al., 2018, Global, regional, and national age-sex-specific mortality for 282 causes of death in 195 countries and territories, 1980-2017: a systematic analysis for the Global Burden of Disease Study 2017, LANCET, Vol: 392, Pages: 1736-1788, ISSN: 0140-6736
Murray CJL, Callender CSKH, Kulikoff XR, et al., 2018, Population and fertility by age and sex for 195 countries and territories, 1950-2017: a systematic analysis for the Global Burden of Disease Study 2017, LANCET, Vol: 392, Pages: 1995-2051, ISSN: 0140-6736
Dicker D, Nguyen G, Abate D, et al., 2018, Global, regional, and national age-sex-specific mortality and life expectancy, 1950-2017: a systematic analysis for the Global Burden of Disease Study 2017, LANCET, Vol: 392, Pages: 1684-1735, ISSN: 0140-6736
James SLG, Abate D, Abate KH, et al., 2018, Global, regional, and national incidence, prevalence, and years lived with disability for 354 diseases and injuries for 195 countries and territories, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017, LANCET, Vol: 392, Pages: 1789-1858, ISSN: 0140-6736
Kyu HH, Abate D, Abate KH, et al., 2018, Global, regional, and national disability-adjusted life-years (DALYs) for 359 diseases and injuries and healthy life expectancy (HALE) for 195 countries and territories, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017, LANCET, Vol: 392, Pages: 1859-1922, ISSN: 0140-6736
Stanaway JD, Afshin A, Gakidou E, et al., 2018, Global, regional, and national comparative risk assessment of 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks for 195 countries and territories, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017, LANCET, Vol: 392, Pages: 1923-1994, ISSN: 0140-6736
Steel N, Ford JA, Newton JN, et al., 2018, Changes in health in the countries of the UK and 150 English Local Authority areas 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016, LANCET, Vol: 392, Pages: 1647-1661, ISSN: 0140-6736
Fitzmaurice C, Akinyemiju TF, Al Lami FH, et al., 2018, Global, Regional, and National Cancer Incidence, Mortality, Years of Life Lost, Years Lived With Disability, and Disability-Adjusted Life-Years for 29 Cancer Groups, 1990 to 2016 A Systematic Analysis for the Global Burden of Disease Study, JAMA ONCOLOGY, Vol: 4, Pages: 1553-1568, ISSN: 2374-2437
Shather Z, Laverty AA, Bottle A, et al., 2018, Sustained Socioeconomic Inequalities in Hospital Admissions for Cardiovascular Events Among People with Diabetes in England, AMERICAN JOURNAL OF MEDICINE, Vol: 131, Pages: 1340-1348, ISSN: 0002-9343
Alexakis C, Saxena S, Chhaya V, et al., 2018, Smoking Status at Diagnosis and Subsequent Smoking Cessation: Associations With Corticosteroid Use and Intestinal Resection in Crohn's Disease, AMERICAN JOURNAL OF GASTROENTEROLOGY, Vol: 113, Pages: 1689-1700, ISSN: 0002-9270
Elmontsri M, Banarsee R, Majeed A, 2018, Improving patient safety in developing countries - moving towards an integrated approach., JRSM Open, Vol: 9, ISSN: 2054-2704
Patient safety is a major public health issue. It has also been recognised as an area for improvement. The purpose of this article is to discuss the need for developing an integrated approach to patient safety improvement in developing countries. Relevant literature to identify the common themes and patterns associated with patient safety improvement was conducted through a search of the online databases (MEDLINE, EMBASE, PUBMED and Google Scholar) for the years 2000 to 2017. Lessons and interventions from developed countries have been taken into consideration to identify the themes needed for patient safety improvement in developing countries. This review provides an integrated approach based on best practice which can be used to guide the development of a national strategy for improving patient safety. Policy makers need to focus on developing a holistic and comprehensive approach to patient safety improvement that takes into account the themes discussed in this article.
Vamos E, Shather Z, Laverty A, et al., 2018, Socio-economic inequalities in hospital admissions for major cardiovascular events in people with diabetes in England, 54th Annual Meeting of the European-Association-for-the-Study-of-Diabetes (EASD), Publisher: SPRINGER, Pages: S576-S576, ISSN: 0012-186X
Griswold MG, Fullman N, Hawley C, et al., 2018, Alcohol use and burden for 195 countries and territories, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016, LANCET, Vol: 392, Pages: 1015-1035, ISSN: 0140-6736
Thomson H, Oliver N, Godsland IF, et al., 2018, Protocol for a clinical trial of text messaging in addition to standard care versus standard care alone in prevention of type 2 diabetes through lifestyle modification in India and the UK, BMC ENDOCRINE DISORDERS, Vol: 18, ISSN: 1472-6823
Hayhoe B, Butler CC, Majeed A, et al., 2018, Telling the truth about antibiotics: benefits, harms and moral duty in prescribing for children in primary care, JOURNAL OF ANTIMICROBIAL CHEMOTHERAPY, Vol: 73, Pages: 2298-2304, ISSN: 0305-7453
Alturkistani A, Majeed A, Car J, et al., 2018, Health information technology uses for primary prevention in preventive medicine: a scoping review protocol, BMJ OPEN, Vol: 8, ISSN: 2044-6055
Shaikhan F, Rawaf S, Majeed A, et al., 2018, Knowledge, attitude, perception and practice regarding antimicrobial use in upper respiratory tract infections in Qatar: a systematic review., JRSM Open, Vol: 9, ISSN: 2054-2704
Objective: To explore the knowledge, attitude, perception and practice towards antimicrobial use in upper respiratory tract infections in patients visiting healthcare settings in Qatar. Design: Systematic review was performed using a predetermined protocol and in accordance with standardized reporting guidelines. MEDLINE, PubMed, EMBASE, Global Health and PsycINFO were searched for relevant published studies using relevant MESH terms and keywords. Setting: All healthcare settings in Qatar including both inpatient and ambulatory care. Participants: All published articles exploring the antimicrobial use in upper respiratory tract infections at any health setting in Qatar were considered for inclusion in the study. No age, gender or population were excluded. Main Outcome Measures: The outcome of interest was antimicrobial use in upper respiratory tract infections in Qatar. We included all related studies to explore the knowledge, attitude, perception and practice for patients visiting all health care settings. Results: Three articles were included, one in a primary care setting, one in a secondary care setting and one in the private sector. Overprescribing was noted in all settings. Our findings demonstrate low expectations to receive antibiotics, among the Qatari population, in primary care (28.1%). In fact, the majority of patients would be satisfied with reassurance rather than receiving antimicrobials. Many patients were satisfied with explanation from physicians and counselling. Private sector registered high prevalence of antimicrobial misuse for respiratory tract infections in which 85% deemed inappropriate. This finding was also noted at a medical intensive care unit which showed high antimicrobial use (76%) and respiratory tract infections accounted for 57% of prescriptions. Conclusion: Studies are needed to determine factors and population-based rates of antimicrobial use in all healthcare settings. There is also a need for interventional programs for both ph
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