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Wang X, Sanders HM, Liu Y, et al., 2023, ChatGPT: promise and challenges for deployment in low- and middle-income countries., Lancet Reg Health West Pac, Vol: 41
In low- and middle-income countries (LMICs), the fields of medicine and public health grapple with numerous challenges that continue to hinder patients' access to healthcare services. ChatGPT, a publicly accessible chatbot, has emerged as a potential tool in aiding public health efforts in LMICs. This viewpoint details the potential benefits of employing ChatGPT in LMICs to improve medicine and public health encompassing a broad spectrum of domains ranging from health literacy, screening, triaging, remote healthcare support, mental health support, multilingual capabilities, healthcare communication and documentation, medical training and education, and support for healthcare professionals. Additionally, we also share potential concerns and limitations associated with the use of ChatGPT and provide a balanced discussion on the opportunities and challenges of using ChatGPT in LMICs.
Chan DYS, Surendra NK, Ng YZ, et al., 2023, Prospective study on the clinical and economic burden of venous leg ulcers in the tropics., J Vasc Surg Venous Lymphat Disord, Vol: 11, Pages: 954-963
OBJECTIVE: Venous leg ulcers (VLUs) are both chronic and recurrent. The treatment of such ulcers often require multiple outpatient visits and dressing changes. Several reports on the costs of treating such VLUs have been reported in the west. We prospectively evaluated the clinical and economic burden of VLUs in a population of Asian patients in the tropics. METHODS: Patients from a prospective two-center study conducted at two tertiary hospitals in Singapore, as a part of the Wound Care Innovation in the Tropics program, between August 2018 and September 2021 were recruited. The patients were followed up for 12 weeks (visit 1 to visit 12), until index ulcer healing, death, or lost to follow-up (whichever came first). These patients were then followed up 12 weeks later to determine the longer term outcome of the wound (healed, recurrence, remained unhealed). The itemized costs derived from the medical service were retrieved from the relevant departments of the study sites. The patients' health-related quality of life was assessed at baseline and the last visit of the 12-week follow-up period (or until index ulcer healing), using the official Singapore version of the EuroQol five-dimension-5L questionnaire, which also includes a visual analog scale (EQ-VAS). RESULTS: A total of 116 patients were enrolled; 63% were men, and the mean patient age was 64.7 years. Of the 116 patients, 85 (73%) had a healed ulcer at 24 weeks (mean duration to ulcer healing, 49 days), and 11 (12.9%) had experienced ulcer recurrence within the study period. Within the 6-month follow-up period, the mean direct healthcare cost per patient was USD$1998. The patients with healed ulcers had significantly lower costs per patient compared with those with unhealed ulcers (USD$1713 vs USD$2780). Regarding health-related quality of life, 71% of the patients had a lower quality of life at baseline, which had improved at 12 weeks of follow-up, with only 58% of the patients reported t
Shin YH, Hwang J, Kwon R, et al., 2023, Global, regional, and national burden of allergic disorders and their risk factors in 204 countries and territories, from 1990 to 2019: A systematic analysis for the Global Burden of Disease Study 2019., Allergy, Vol: 78, Pages: 2232-2254
BACKGROUND: Asthma and atopic dermatitis (AD) are chronic allergic conditions, along with allergic rhinitis and food allergy and cause high morbidity and mortality both in children and adults. This study aims to evaluate the global, regional, national, and temporal trends of the burden of asthma and AD from 1990 to 2019 and analyze their associations with geographic, demographic, social, and clinical factors. METHODS: Using data from the Global Burden of Diseases (GBD), Injuries, and Risk Factors Study 2019, we assessed the age-standardized prevalence, incidence, mortality, and disability-adjusted life years (DALYs) of both asthma and AD from 1990 to 2019, stratified by geographic region, age, sex, and socio-demographic index (SDI). DALYs were calculated as the sum of years lived with disability and years of life lost to premature mortality. Additionally, the disease burden of asthma attributable to high body mass index, occupational asthmagens, and smoking was described. RESULTS: In 2019, there were a total of 262 million [95% uncertainty interval (UI): 224-309 million] cases of asthma and 171 million [95% UI: 165-178 million] total cases of AD globally; age-standardized prevalence rates were 3416 [95% UI: 2899-4066] and 2277 [95% UI: 2192-2369] per 100,000 population for asthma and AD, respectively, a 24.1% [95% UI: -27.2 to -20.8] decrease for asthma and a 4.3% [95% UI: 3.8-4.8] decrease for AD compared to baseline in 1990. Both asthma and AD had similar trends according to age, with age-specific prevalence rates peaking at age 5-9 years and rising again in adulthood. The prevalence and incidence of asthma and AD were both higher for individuals with higher SDI; however, mortality and DALYs rates of individuals with asthma had a reverse trend, with higher mortality and DALYs rates in those in the lower SDI quintiles. Of the three risk factors, high body mass index contributed to the highest DALYs and deaths due to asthma, accounting for a total of 3.65 mil
Lin X, Martinengo L, Jabir AI, et al., 2023, Scope, Characteristics, Behavior Change Techniques, and Quality of Conversational Agents for Mental Health and Well-Being: Systematic Assessment of Apps., J Med Internet Res, Vol: 25
BACKGROUND: Mental disorders cause substantial health-related burden worldwide. Mobile health interventions are increasingly being used to promote mental health and well-being, as they could improve access to treatment and reduce associated costs. Behavior change is an important feature of interventions aimed at improving mental health and well-being. There is a need to discern the active components that can promote behavior change in such interventions and ultimately improve users' mental health. OBJECTIVE: This study systematically identified mental health conversational agents (CAs) currently available in app stores and assessed the behavior change techniques (BCTs) used. We further described their main features, technical aspects, and quality in terms of engagement, functionality, esthetics, and information using the Mobile Application Rating Scale. METHODS: The search, selection, and assessment of apps were adapted from a systematic review methodology and included a search, 2 rounds of selection, and an evaluation following predefined criteria. We conducted a systematic app search of Apple's App Store and Google Play using 42matters. Apps with CAs in English that uploaded or updated from January 2020 and provided interventions aimed at improving mental health and well-being and the assessment or management of mental disorders were tested by at least 2 reviewers. The BCT taxonomy v1, a comprehensive list of 93 BCTs, was used to identify the specific behavior change components in CAs. RESULTS: We found 18 app-based mental health CAs. Most CAs had <1000 user ratings on both app stores (12/18, 67%) and targeted several conditions such as stress, anxiety, and depression (13/18, 72%). All CAs addressed >1 mental disorder. Most CAs (14/18, 78%) used cognitive behavioral therapy (CBT). Half (9/18, 50%) of the CAs identified were rule based (ie, only offered predetermined answers) and the other half (9/18, 50%) were artificial intelligence enhanced (ie, included o
Bojic I, Mammadova M, Ang C-S, et al., 2023, Empowering Health Care Education Through Learning Analytics: In-depth Scoping Review., J Med Internet Res, Vol: 25
BACKGROUND: Digital education has expanded since the COVID-19 pandemic began. A substantial amount of recent data on how students learn has become available for learning analytics (LA). LA denotes the "measurement, collection, analysis, and reporting of data about learners and their contexts, for purposes of understanding and optimizing learning and the environments in which it occurs." OBJECTIVE: This scoping review aimed to examine the use of LA in health care professions education and propose a framework for the LA life cycle. METHODS: We performed a comprehensive literature search of 10 databases: MEDLINE, Embase, Web of Science, ERIC, Cochrane Library, PsycINFO, CINAHL, ICTP, Scopus, and IEEE Explore. In total, 6 reviewers worked in pairs and performed title, abstract, and full-text screening. We resolved disagreements on study selection by consensus and discussion with other reviewers. We included papers if they met the following criteria: papers on health care professions education, papers on digital education, and papers that collected LA data from any type of digital education platform. RESULTS: We retrieved 1238 papers, of which 65 met the inclusion criteria. From those papers, we extracted some typical characteristics of the LA process and proposed a framework for the LA life cycle, including digital education content creation, data collection, data analytics, and the purposes of LA. Assignment materials were the most popular type of digital education content (47/65, 72%), whereas the most commonly collected data types were the number of connections to the learning materials (53/65, 82%). Descriptive statistics was mostly used in data analytics in 89% (58/65) of studies. Finally, among the purposes for LA, understanding learners' interactions with the digital education platform was cited most often in 86% (56/65) of papers and understanding the relationship between interactions and student performance was cited in 63% (41/65) of papers. Far less
Tan BY, Goh ZZS, Lim CJ, et al., 2023, Singapore KneE osTeoarthritis CoHort (SKETCH): protocol for a multi-centre prospective cohort study, BMC MUSCULOSKELETAL DISORDERS, Vol: 24
Teixeira F, Li E, Laranjo L, et al., 2023, Digital maturity and its determinants in General Practice: a cross- sectional study in 20 countries, Frontiers in Public Health, Vol: 10, Pages: 1-10, ISSN: 2296-2565
Background: The extent to which digital technologies are employed to promote the delivery of high-quality healthcare is known as Digital Maturity. Individual and systemic digital maturity are both necessary to ensure a successful, scalable and sustainable digital transformation in healthcare. However, digital maturity in primary care has been scarcely evaluated.Objectives: This study assessed the digital maturity in General Practice (GP) globally and evaluated its association with participants' demographic characteristics, practice characteristics and features of Electronic Health Records (EHRs) use.Methods: GPs across 20 countries completed an online questionnaire between June and September 2020. Demographic data, practice characteristics, and features of EHRs use were collected. Digital maturity was evaluated through a framework based on usage, resources and abilities (divided in this study in its collective and individual components), interoperability, general evaluation methods and impact of digital technologies. Each dimension was rated as 1 or 0. The digital maturity score was calculated as the sum of the six dimensions and ranged between 0 to 6 (maximum digital maturity). Multivariable linear regression was used to model the total score, while multivariable logistic regression was used to model the probability of meeting each dimension of the score.Results: One thousand six hundred GPs (61% female, 68% Europeans) participated. GPs had a median digital maturity of 4 (P25–P75: 3–5). Positive associations with digital maturity were found with: male gender [B = 0.18 (95% CI 0.01; 0.36)], use of EHRs for longer periods [B = 0.45 (95% CI 0.35; 0.54)] and higher frequencies of access to EHRs [B = 0.33 (95% CI 0.17; 0.48)]. Practicing in a rural setting was negatively associated with digital maturity [B = −0.25 (95%CI −0.43; −0.08)]. Usage (90%) was the most acknowledged dimension while interoperability (47%) and use of best practice gen
Pienkowska A, Ang C-S, Mammadova M, et al., 2023, Diabetes education app for people with type 2 diabetes: Co-design study (Preprint), JMIR Formative Research
Lo ZJ, Chong B, Tan E, et al., 2023, Patients, carers and healthcare providers' perspectives on a patient-owned surveillance system for diabetic foot ulcer care: A qualitative study., Digit Health, Vol: 9, ISSN: 2055-2076
OBJECTIVE: Digital health has recently gained a foothold in monitoring and improving diabetes care. We aim to explore the views of patients, carers and healthcare providers (HCPs) regarding the use of a novel patient-owned wound surveillance application as part of outpatient management of patients with diabetic foot ulcers (DFUs). METHODS: Semi-structured online interviews were conducted with patients, carers and HCPs in wound care for DFUs. The participants were recruited from a primary care polyclinic network and two tertiary hospitals in Singapore, within the same healthcare cluster. Purposive maximum variation sampling was used to select participants with differing attributes to ensure heterogeneity. Common themes relating to the wound imaging app were captured. RESULTS: A total of 20 patients, 5 carers and 20 HCPs participated in the qualitative study. None of the participants have used a wound imaging app before. Regarding a patient-owned wound surveillance app, all were open and receptive to the system and workflow for use in DFU care. Four major themes emerged from patients and carers: (1) technology, (2) application features and usability, (3) feasibility of using the wound imaging application and (4) logistics of care. Four major themes were identified from HCPs: (1) attitudes towards wound imaging app, (2) preferences regarding functionality, (3) perceived challenges for patients/carers and (4) perceived barriers for HCPs. CONCLUSION: Our study highlighted several barriers and facilitators from patients, carers and HCPs regarding the use of a patient-owned wound surveillance app. These findings demonstrate the potential of digital health and areas to improve and tailor a DFU wound app suitable for implementation in the local population.
Castro O, Mair JL, Salamanca-Sanabria A, et al., 2023, Development of "LvL UP 1.0": a smartphone-based, conversational agent-delivered holistic lifestyle intervention for the prevention of non-communicable diseases and common mental disorders., Front Digit Health, Vol: 5
BACKGROUND: Non-communicable diseases (NCDs) and common mental disorders (CMDs) are the leading causes of death and disability worldwide. Lifestyle interventions via mobile apps and conversational agents present themselves as low-cost, scalable solutions to prevent these conditions. This paper describes the rationale for, and development of, "LvL UP 1.0″, a smartphone-based lifestyle intervention aimed at preventing NCDs and CMDs. MATERIALS AND METHODS: A multidisciplinary team led the intervention design process of LvL UP 1.0, involving four phases: (i) preliminary research (stakeholder consultations, systematic market reviews), (ii) selecting intervention components and developing the conceptual model, (iii) whiteboarding and prototype design, and (iv) testing and refinement. The Multiphase Optimization Strategy and the UK Medical Research Council framework for developing and evaluating complex interventions were used to guide the intervention development. RESULTS: Preliminary research highlighted the importance of targeting holistic wellbeing (i.e., both physical and mental health). Accordingly, the first version of LvL UP features a scalable, smartphone-based, and conversational agent-delivered holistic lifestyle intervention built around three pillars: Move More (physical activity), Eat Well (nutrition and healthy eating), and Stress Less (emotional regulation and wellbeing). Intervention components include health literacy and psychoeducational coaching sessions, daily "Life Hacks" (healthy activity suggestions), breathing exercises, and journaling. In addition to the intervention components, formative research also stressed the need to introduce engagement-specific components to maximise uptake and long-term use. LvL UP includes a motivational interviewing and storytelling approach to deliver the coaching sessions, as well as progress feedback and gamification. Offline materials are also offered to allow users access to essential intervent
Martinengo L, Lum E, Car J, 2022, Evaluation of chatbot-delivered interventions for self-management of depression: Content analysis, JOURNAL OF AFFECTIVE DISORDERS, Vol: 319, Pages: 598-607, ISSN: 0165-0327
Reiner RC, LBD Triple Burden Collaborators, Hay SI, 2022, The overlapping burden of the three leading causes of disability and death in sub-Saharan African children., Nat Commun, Vol: 13
Despite substantial declines since 2000, lower respiratory infections (LRIs), diarrhoeal diseases, and malaria remain among the leading causes of nonfatal and fatal disease burden for children under 5 years of age (under 5), primarily in sub-Saharan Africa (SSA). The spatial burden of each of these diseases has been estimated subnationally across SSA, yet no prior analyses have examined the pattern of their combined burden. Here we synthesise subnational estimates of the burden of LRIs, diarrhoea, and malaria in children under-5 from 2000 to 2017 for 43 sub-Saharan countries. Some units faced a relatively equal burden from each of the three diseases, while others had one or two dominant sources of unit-level burden, with no consistent pattern geographically across the entire subcontinent. Using a subnational counterfactual analysis, we show that nearly 300 million DALYs could have been averted since 2000 by raising all units to their national average. Our findings are directly relevant for decision-makers in determining which and targeting where the most appropriate interventions are for increasing child survival.
Fadahunsi KP, Wark PA, Mastellos N, et al., 2022, Assessment of clinical information quality in digital health technologies: an international eDelphi study, Journal of Medical Internet Research, Vol: 24, Pages: 1-10, ISSN: 1438-8871
Background:Digital health technologies (DHTs), such as electronic health records and prescribing systems, are transforming health care delivery around the world. The quality of information in DHTs is key to the quality and safety of care. We developed a novel clinical information quality (CLIQ) framework to assess the quality of clinical information in DHTs.Objective:This study explored clinicians’ perspectives on the relevance, definition, and assessment of information quality dimensions in the CLIQ framework.Methods:We used a systematic and iterative eDelphi approach to engage clinicians who had information governance roles or personal interest in information governance; the clinicians were recruited through purposive and snowball sampling techniques. Data were collected using semistructured online questionnaires until consensus was reached on the information quality dimensions in the CLIQ framework. Responses on the relevance of the dimensions were summarized to inform decisions on retention of the dimensions according to prespecified rules. Thematic analysis of the free-text responses was used to revise definitions and the assessment of dimensions.Results:Thirty-five clinicians from 10 countries participated in the study, which was concluded after the second round. Consensus was reached on all dimensions and categories in the CLIQ framework: informativeness (accuracy, completeness, interpretability, plausibility, provenance, and relevance), availability (accessibility, portability, security, and timeliness), and usability (conformance, consistency, and maintainability). A new dimension, searchability, was introduced in the availability category to account for the ease of finding needed information in the DHTs. Certain dimensions were renamed, and some definitions were rephrased to improve clarity.Conclusions:The CLIQ framework reached a high expert consensus and clarity of language relating to the information quality dimensions. The framework can be used b
Amornsriwatanakul A, Rahman HA, Wattanapisit A, et al., 2022, University students' overall and domain-specific physical activity during COVID-19: A cross-sectional study in seven ASEAN countries., Heliyon, Vol: 8, ISSN: 2405-8440
This research investigated the overall and domain-specific physical activity (PA) of university students in the coronavirus disease 2019 (COVID-19) pandemic. A cross-sectional study was applied to socioeconomic (SE) and PA online data collected from 15,366 students across 17 universities in seven Association of Southeast Asian Nations (ASEAN) countries. Statistical analyses using logistic regressions established SE-PA relationships. Over half (60.3%) of ASEAN university students met age-span specific PA guidelines. Students participated in recreational PA the most, followed by study-related activities and 44.1% of students engaged in >8 hrs/day of sedentary time (ST). Compared to students with a normal body mass index (BMI), students who were underweight (UW), overweight (OW), and obese (OB) respectively, had a 14% (UW odds ratio (OR) = 1.14, p = 0.005), 25% (OW OR = 1.25, p < 0.001), and 24% (OB OR = 1.24, p = 0.005) greater probability of meeting PA guidelines. Those who engaged in active transport and belonged to a sports club (SC) had 42% (SC OR = 0.58, p < 0.001, for both) less probability of meeting the PA guidelines, compared with those who travelled inactively and did not belong to a sports club, respectively. Students who participated in 4-6 sport or exercise activities had ten times more likelihood of meeting PA guidelines (OR = 10.15, p < 0.001), compared with those who did not play any sport or do any exercise. Students who spent >8 hrs/day of ST had 32% (ST OR = 0.68, p < 0.001) less probability of meeting PA guidelines, compared with those who spent <3 hrs of ST. These data showed that over half of ASEAN university students achieved PA guidelines and were highly sedentary during the COVID-19 pandemic. Recreational and study-related activities were important for students to maintain sufficient PA and should be actively promoted within the restrictions imposed during periods of the COVID-19 pandemic lockdowns.
Lo ZJ, Tan E, Chandrasekar S, et al., 2022, Diabetic foot in primary and tertiary (DEFINITE) Care: A health services innovation in coordination of diabetic foot ulcer (DFU) Care within a healthcare cluster-18-month results from an observational population health cohort study, INTERNATIONAL WOUND JOURNAL, ISSN: 1742-4801
Lee KFA, Lee EH, Roberts AC, et al., 2022, Effects of fun-seeking and external locus of control on smoking behaviour: a cross-sectional analysis on a cohort of working men in Singapore, BMJ OPEN, Vol: 12, ISSN: 2044-6055
Wattanapisit A, Abdul Rahman H, Car J, et al., 2022, The clusters of health-risk behaviours and mental wellbeing and their sociodemographic correlates: a study of 15,366 ASEAN university students, BMC PUBLIC HEALTH, Vol: 22
Frostad JJ, Nguyen QP, Baumann MM, et al., 2022, Mapping development and health effects of cooking with solid fuels in low-income and middle-income countries, 2000–18: a geospatial modelling study, The Lancet Global Health, Vol: 10, Pages: e1395-e1411, ISSN: 2214-109X
BackgroundMore than 3 billion people do not have access to clean energy and primarily use solid fuels to cook. Use of solid fuels generates household air pollution, which was associated with more than 2 million deaths in 2019. Although local patterns in cooking vary systematically, subnational trends in use of solid fuels have yet to be comprehensively analysed. We estimated the prevalence of solid-fuel use with high spatial resolution to explore subnational inequalities, assess local progress, and assess the effects on health in low-income and middle-income countries (LMICs) without universal access to clean fuels.MethodsWe did a geospatial modelling study to map the prevalence of solid-fuel use for cooking at a 5 km × 5 km resolution in 98 LMICs based on 2·1 million household observations of the primary cooking fuel used from 663 population-based household surveys over the years 2000 to 2018. We use observed temporal patterns to forecast household air pollution in 2030 and to assess the probability of attaining the Sustainable Development Goal (SDG) target indicator for clean cooking. We aligned our estimates of household air pollution to geospatial estimates of ambient air pollution to establish the risk transition occurring in LMICs. Finally, we quantified the effect of residual primary solid-fuel use for cooking on child health by doing a counterfactual risk assessment to estimate the proportion of deaths from lower respiratory tract infections in children younger than 5 years that could be associated with household air pollution.FindingsAlthough primary reliance on solid-fuel use for cooking has declined globally, it remains widespread. 593 million people live in districts where the prevalence of solid-fuel use for cooking exceeds 95%. 66% of people in LMICs live in districts that are not on track to meet the SDG target for universal access to clean energy by 2030. Household air pollution continues to be a major contributor to particulate exposure
Osman T, Lew E, Sng BL, et al., 2022, Assessment of inter-rater agreement of the American Society of Anesthesiologists physical status classification system in a women's tertiary hospital An observational study, EUROPEAN JOURNAL OF ANAESTHESIOLOGY, Vol: 39, Pages: 787-788, ISSN: 0265-0215
Rahman HA, Amornsriwatanakul A, Abdul-Mumin KH, et al., 2022, Prevalence of Health-Risk Behaviors and Mental Well-Being of ASEAN University Students in COVID-19 Pandemic, INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH, Vol: 19
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Surendran S, Foo CD, Matchar DB, et al., 2022, Developing integration among stakeholders in the primary care networks of Singapore: a qualitative study, BMC HEALTH SERVICES RESEARCH, Vol: 22
Li E, Tsopra R, Jimenez G, et al., 2022, General practitioners’ perceptions of using virtual primary care during the COVID-19 pandemic: An international cross-sectional survey study, PLOS Digital Health, Vol: 1, Pages: 1-23, ISSN: 2767-3170
With the onset of COVID-19, general practitioners (GPs) and patients worldwide swiftly transitioned from face-to-face to digital remote consultations. There is a need to evaluate how this global shift has impacted patient care, healthcare providers, patient and carer experience, and health systems. We explored GPs’ perspectives on the main benefits and challenges of using digital virtual care. GPs across 20 countries completed an online questionnaire between June–September 2020. GPs’ perceptions of main barriers and challenges were explored using free-text questions. Thematic analysis was used to analyse the data. A total of 1,605 respondents participated in our survey. The benefits identified included reducing COVID-19 transmission risks, guaranteeing access and continuity of care, improved efficiency, faster access to care, improved convenience and communication with patients, greater work flexibility for providers, and hastening the digital transformation of primary care and accompanying legal frameworks. Main challenges included patients’ preference for face-to-face consultations, digital exclusion, lack of physical examinations, clinical uncertainty, delays in diagnosis and treatment, overuse and misuse of digital virtual care, and unsuitability for certain types of consultations. Other challenges include the lack of formal guidance, higher workloads, remuneration issues, organisational culture, technical difficulties, implementation and financial issues, and regulatory weaknesses. At the frontline of care delivery, GPs can provide important insights on what worked well, why, and how during the pandemic. Lessons learned can be used to inform the adoption of improved virtual care solutions and support the long-term development of platforms that are more technologically robust and secure.
Lee KFA, Chan E, Car J, et al., 2022, Lowering the Sampling Rate: Heart Rate Response during Cognitive Fatigue, BIOSENSORS-BASEL, Vol: 12
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Dutta O, Tan-Ho G, Low XC, et al., 2022, Acceptability and feasibility of a pilot randomized controlled trial of Narrative e-Writing Intervention (NeW-I) for parent-caregivers of children with chronic life-threatening illnesses in Singapore, BMC PALLIATIVE CARE, Vol: 21, ISSN: 1472-684X
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Fadahunsi P, Wark P, Mastellos N, et al., 2022, Clinical information quality of digital health technologies: protocol for an international eDelphi study, BMJ Open, Vol: 12, ISSN: 2044-6055
Introduction Digital health technologies (DHTs) such as electronic health records, clinical decision support systems and electronic prescribing systems are widely used in healthcare. While adoption of DHTs can improve healthcare delivery, information quality (IQ) problems associated with DHTs can compromise quality and safety of care. The clinical information quality (CLIQ) framework for digital health is a novel approach to assessing the quality of clinical information from DHTs. This study aims to appraise the CLIQ framework by exploring clinicians’ perspectives on the relevance, definition and assessment of IQ dimensions as defined in the framework. This study will adapt the CLIQ framework to the needs of clinical information users—the clinicians. The contextualised CLIQ framework will offer a pragmatic approach to assessing clinical information from DHTs and may help to forestall IQ problems that can compromise quality and safety of care.Methods and analysis The electronic Delphi (eDelphi) approach will be used to engage a heterogeneous group of clinicians with patient-facing and/or information governance roles recruited through purposive and snowball sampling techniques. A semi-structured online questionnaire will be used to explore clinicians’ perspectives on relevance, definition and assessment of IQ dimensions in the CLIQ framework. Survey responses on the relevance of dimensions will be summarised using descriptive statistics to inform decisions on retention of dimensions and termination of the study, based on pre-specified rules. Analysis of the free-text responses will be used to revise definition and assessment of dimensions.Ethics and dissemination Ethics approval has been obtained from the Imperial College Research Governance and Integrity Team (Imperial College Research Ethics Committee (ICREC) Reference number: 20IC6396). The results of the study will be published in a peer-reviewed journal and presented at scientific conferences.
Surendran S, De Foo C, Tam CH, et al., 2022, Reply to Ngoh et al. Comment on "Surendran et al. The Missed Opportunity of Patient-Centered Medical Homes to Thrive in an Asian Context. Int. J. Environ. Res. Public Health 2021, 18, 1817", INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH, Vol: 19
Osman T, Lew E, Sng BL, et al., 2022, Delphi consensus on the American Society of Anesthesiologists' physical status classification in an Asian tertiary women's hospital, KOREAN JOURNAL OF ANESTHESIOLOGY, Vol: 75, Pages: 168-177, ISSN: 2005-6419
Essen A, Stern AD, Haase CB, et al., 2022, Health app policy: international comparison of nine countries' approaches, NPJ DIGITAL MEDICINE, Vol: 5, ISSN: 2398-6352
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Tudor Car L, 2022, Digital education for health professionals: An evidence map, conceptual framework and research agenda, Journal of Medical Internet Research, Vol: 24, Pages: 1-21, ISSN: 1438-8871
BackgroundHealth professions education has undergone major changes with the advent and adoption of digital technologies worldwide. To enable robust and relevant research in digital health professions education, it is essential to map the existing evidence, identify gaps and research priorities.MethodsWe searched for systematic reviews on digital education of practicing and student healthcare professionals. We searched Medline, Embase, Cochrane Library, ERIC, CINAHL, and grey literature sources from January 2014 to July 2020. Two authors independently screened the studies, extracted the data, and synthesized the findings. We outlined the key characteristics of the included reviews, the quality of the evidence they synthesized, and recommendations for future research. We mapped the empiric findings and research recommendations against a newly developed conceptual framework. ResultsWe identified 77 eligible systematic reviews. All included experimental studies and evaluated the effectiveness of digital education interventions in different healthcare disciplines or of different digital education modalities. Most reviews included studies on various digital education modalities (N=22), virtual reality (N=19) and online education (N=10). Most reviews focused on health professions education in general (N=36), surgery (N=13) and nursing (N=11). The reviews mainly assessed participants’ skills (N=51) and knowledge (N=49) and included data from high-income countries (N=53). Our novel conceptual framework of digital health professions education comprises six key domains (context, infrastructure, education, learners, research, and quality improvement) and 16 subdomains. Finally, we identified in these reviews 61 unique questions for future research; these mapped to framework domains of education (29 recommendations), context (17), infrastructure (9), learners (3), and research (3). Conclusions We have identified a large number of research questions regarding digital educat
Kusuma D, 2022, Global, regional, and national burden of diseases and injuries for adults 70 years and older: systematic analysis for the Global Burden of Disease 2019 Study, BMJ: British Medical Journal, Vol: 376, Pages: e068208-e068208, ISSN: 0959-535X
Objectives To use data from the Global Burden of Diseases, Injuries, and Risk Factors Study 2019 (GBD 2019) to estimate mortality and disability trends for the population aged ≥70 and evaluate patterns in causes of death, disability, and risk factors.Design Systematic analysis.Setting Participants were aged ≥70 from 204 countries and territories, 1990-2019.Main outcomes measures Years of life lost, years lived with disability, disability adjusted life years, life expectancy at age 70 (LE-70), healthy life expectancy at age 70 (HALE-70), proportion of years in ill health at age 70 (PYIH-70), risk factors, and data coverage index were estimated based on standardised GBD methods.Results Globally the population of older adults has increased since 1990 and all cause death rates have decreased for men and women. However, mortality rates due to falls increased between 1990 and 2019. The probability of death among people aged 70-90 decreased, mainly because of reductions in non-communicable diseases. Globally disability burden was largely driven by functional decline, vision and hearing loss, and symptoms of pain. LE-70 and HALE-70 showed continuous increases since 1990 globally, with certain regional disparities. Globally higher LE-70 resulted in higher HALE-70 and slightly increased PYIH-70. Sociodemographic and healthcare access and quality indices were positively correlated with HALE-70 and LE-70. For high exposure risk factors, data coverage was moderate, while limited data were available for various dietary, environmental or occupational, and metabolic risks.Conclusions Life expectancy at age 70 has continued to rise globally, mostly because of decreases in chronic diseases. Adults aged ≥70 living in high income countries and regions with better healthcare access and quality were found to experience the highest life expectancy and healthy life expectancy. Disability burden, however, remained constant, suggesting the need to enhance public health and intervent
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