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Khaing NEE, Abuduxike G, Posadzki P, et al., 2019, Review of the potential health effects of light and environmental exposures in underground workplaces, TUNNELLING AND UNDERGROUND SPACE TECHNOLOGY, Vol: 84, Pages: 201-209, ISSN: 0886-7798
Paranjape K, Car J, Parker M, et al., 2019, Implementation Considerations for Blockchain in Healthcare Institutions (Preprint)
<sec> <title>BACKGROUND</title> <p>Healthcare is undergoing a transformation worldwide1. In many developed countries, mature but antiqued national healthcare services are being burdened with a growing aging population, changes in payment reforms, worker shortage and rising costs2. Combined with a surge in innovative technologies like Artificial Intelligence (AI)3 and blockchain4 which can help with automating medical record mining to provide a more accurate diagnosis5 or reduce errors in medical practice6 by providing accurate and tailored treatment while reducing the financial burden, today’s healthcare systems are ready for change. After success in industries like financial services7 and retail8, if blockchain can be scaled and moved into the mainstream in healthcare, it can help alleviate the many concerns with security and privacy of health data and help stitch together a longitudinal history of health data that is fragmented and locked away in multiple silos today. Sophisticated use of blockchain technology will contribute to improving health outcomes, improved health care quality, and lower health care costs – the three overarching aims that the U.S. is striving to achieve (also known as the “Triple aim”)9.</p> </sec> <sec> <title>OBJECTIVE</title> <p>This paper aims to provide a primer on blockchain technology, and implementation considerations for blockchain at healthcare institutions.</p> </sec> <sec> <title>METHODS</title> <p>Systematic literature survey, conversation with experts.</p> </sec> <sec> <title>RESULTS</title>
Jimenez G, Lum E, Car J, 2019, Examining Diabetes Management Apps Recommended From a Google Search: Content Analysis, JMIR MHEALTH AND UHEALTH, Vol: 7, ISSN: 2291-5222
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- Citations: 34
Paranjape K, Parker M, Houlding D, et al., 2019, Implementation Considerations for Blockchain in Healthcare Institutions, Blockchain in Healthcare Today, Vol: 2
Objective: This article aims to provide a primer on blockchain technology and implementation considerations for blockchain at healthcare institutions. Results: After research and interviews, we developed a primer and a high-level implementation guide for healthcare systems exploring the use of blockchain technology. Conclusions: The use of blockchain technology in health care is at a promising stage in development but blockchain-based applications are yet to be demonstrated as a viable platform for exchanging and reviewing information. Healthcare systems should be cautiously optimistic regarding the potential of blockchain and do a thorough business and technical diligence that is driven by targeted use cases to be successful.
George PP, Zhabenko O, Kyaw BM, et al., 2019, Online Digital Education for Postregistration Training of Medical Doctors: Systematic Review by the Digital Health Education Collaboration (Preprint)
<sec> <title>BACKGROUND</title> <p>Globally, online and local area network–based (LAN) digital education (ODE) has grown in popularity. Blended learning is used by ODE along with traditional learning. Studies have shown the increasing potential of these technologies in training medical doctors; however, the evidence for its effectiveness and cost-effectiveness is unclear.</p> </sec> <sec> <title>OBJECTIVE</title> <p>This systematic review evaluated the effectiveness of online and LAN-based ODE in improving practicing medical doctors’ knowledge, skills, attitude, satisfaction (primary outcomes), practice or behavior change, patient outcomes, and cost-effectiveness (secondary outcomes).</p> </sec> <sec> <title>METHODS</title> <p>We searched seven electronic databased for randomized controlled trials, cluster-randomized trials, and quasi-randomized trials from January 1990 to March 2017. Two review authors independently extracted data and assessed the risk of bias. We have presented the findings narratively. We mainly compared ODE with self-directed/face-to-face learning and blended learning with self-directed/face-to-face learning.</p> </sec> <sec> <title>RESULTS</title> <p>A total of 93 studies (N=16,895) were included, of which 76 compared ODE (including blended) and self-directed/face-to-face learning. Overall, the effect of ODE (including blended) on postintervention knowledge, skills, attitude, satisfaction, practice or behavior change, and patient outcomes was inconsistent and ranged mostly from no difference between the
Olsson M, Järbrink K, Divakar U, et al., 2019, The humanistic and economic burden of chronic wounds: A systematic review, Wound Repair and Regeneration, Vol: 27, Pages: 114-125, ISSN: 1067-1927
Chronic wounds are a health problem that have devastating consequences for patients and contribute major costs to healthcare systems and societies. To understand the magnitude of this health issue, a systematic review was undertaken. Searches were conducted in MEDLINE, EMBASE, EBM Reviews and Cochrane library, CINAHL, EBSCO, PsycINFO, and Global Health databases for articles published between 2000 and 2015. Included publications had to target adults (≥18 years of age), state wound chronicity (≥3 weeks) and/or label the wounds as chronic, complex, hard-to-heal, or having led to an amputation. The review excluded studies that did not present data on generic health-related quality of life and/or cost data, case studies, randomized controlled trials, economic modeling studies, abstracts, and editorials. Extracted data were summarized into a narrative synthesis, and for a few articles using the same health-related quality of life instrument, average estimates with 95% confidence intervals were calculated. Thirty articles met the inclusion criteria. Findings revealed that health-related quality of life was lowest for physical pathologies, and based on average estimates were scores most inferior in the domain physical role for both patients with chronic wounds and for those with wound-related amputations. The cost burden was mainly attributed to amputations for patients also comorbid with diabetes, where the cost for hospitalization ranged from US$12,851 to US$16,267 (median) for this patient group. Patients with chronic wounds have poor health-related quality of life in general and wound-related costs are substantial. Development and implementation of wound management strategies that focus on increasing health-related quality of life and effectively reduce costs for this patient group are urgently needed.
Xu X, Posadzki PP, Lee GE, et al., 2019, Digital Education for Health Professions in the Field of Dermatology: A Systematic Review by Digital Health Education Collaboration, ACTA DERMATO-VENEREOLOGICA, Vol: 99, Pages: 133-138, ISSN: 0001-5555
Roberts AC, Christopoulos GI, Yap HS, et al., 2019, Attention and vigilance: A large scale workplace study, Pages: 151-158, ISSN: 2194-5357
Many previous studies have examined the effect of working environment on job performance. However, these are usually site-specific experiments examining office workers, concentrating on self-report measures and peer assessments. An area of particular interest is whether computerised tests could be used to identify deficits in performance and associate these with specific environmental problems. We recruited over four hundred participants from several companies in Singapore, spanning a range of job types requiring different levels of visual attention, broadly grouped as technical workshop staff, office staff, and operational control room workers. Where possible, job types were matched across companies. Participants were given a series of psychological, environmental, and health-related questionnaires and computerised tests examining various aspects of visual attention (psychomotor vigilance task, go-nogo task and global-local change detection) as analogues of work performance. Mixed effect models were used to examine the workers’ performance, taking into account work-related, environmental, and health related factors. Results indicate variability across companies and job types, effects of shift work, and some effects of environment on vigilant and selective attention.
Meinert E, Alturkistani A, Luo D, et al., 2019, Current status and future direction of companion diagnostics, Companion and Complementary Diagnostics: From Biomarker Discovery to Clinical Implementation, Pages: 455-472, ISBN: 9780128135402
This chapter will introduce companion diagnostics (CDxes), its current status, economic and regulatory aspects of CDx, and its future potential while discussing specific disease areas as well as the analytical technologies that are likely to dominate. It will first start by providing an overview of CDx, its definition, and some of the mechanisms that underlie its development. The chapter will then discuss the current status of CDx, its uses in medicine, and critical aspects of its development demonstrated in the discussion about codevelopment, with factors contributing to a market size exceeding 2 billion US dollars. An overview of the present economic and regulatory issues will also be discussed. Specific disease areas such as oncology, aging-related diseases, and other diseases will be considered concerning their future aspects in the use of CDx and the analytical technologies that will underlie their development.
Martinengo L, Olsson M, Bajpai R, et al., 2019, Prevalence of chronic wounds in the general population: Systematic review and meta-analysis of observational studies, Annals of Epidemiology, Vol: 29, Pages: 8-15, ISSN: 1047-2797
Purpose Chronic wounds are a major public health challenge, but little is known about the true burden with studies reporting different estimates due to disparities in study designs and measurement methods. This hampers efficient resource allocation, planning and improvement of wound care Methods Our study aimed to pool prevalence estimates from a global perspective by systematically carrying out searches in MEDLINE, EMBASE, Cochrane, CINAHL, Global Health, and PsycINFO databases for papers reporting the prevalence of chronic wounds in adults, from January 2000 to June 2018. The included publications had to define wound chronicity by duration (≥3 weeks), and/or labelling the wounds as chronic, complex or hard-to-heal. Results Seventeen studies met the inclusion criteria, and 11 studies analysing chronic wounds in the general population were included in random effects meta-analyses to calculate pooled prevalence. Chronic wounds of mixed aetiologies (n=3) showed a pooled prevalence of 2.21 per 1,000 population, and for chronic leg ulcers (n=9) the prevalence was estimated at 1.51 per 1,000 population. Conclusions Our findings, aligned to previous studies reporting point prevalence of chronic wounds identified within the healthcare system, showed that the vast majority of chronic wounds in epidemiological studies are made up by chronic leg ulcers.
Meinert E, Eerens J, Banks C, et al., 2019, A CASE STUDY EXAMINING THE COST MEASUREMENTS IN PRODUCTION AND DELIVERY OF A SMALL PRIVATE ONLINE COURSE (SPOC) FOR TEACHING ADMINISTRATIVE STAFF TO ENGAGE WITH YOUNG PATIENTS, 11th International Conference on Education and New Learning Technologies (EDULEARN), Publisher: IATED-INT ASSOC TECHNOLOGY EDUCATION & DEVELOPMENT, Pages: 6458-6466, ISSN: 2340-1117
Soh C-K, Marimuther V, Christopoulos GI, et al., 2019, Underground Workspaces: A Human Factors Approach, 20th Congress of the International-Ergonomics-Association (IEA), Publisher: SPRINGER INTERNATIONAL PUBLISHING AG, Pages: 764-772, ISSN: 2194-5357
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- Citations: 2
Udeh-Momoh C, Price G, Ropacki M, et al., 2019, Prospective Evaluation of Cognitive Health and Related Factors in Elderly at Risk for Developing Alzheimer’s Dementia: A Longitudinal Cohort study, The Journal of Prevention of Alzheimer's Disease, ISSN: 2274-5807
Kyaw BM, Posadzki P, Paddock S, et al., 2018, Effectiveness of Digital Education on Communication Skills Among Medical Students: Systematic Review and Meta-Analysis by the Digital Health Education Collaboration (Preprint)
<sec> <title>BACKGROUND</title> <p>Effective communication skills are essential in diagnosis and treatment processes and in building the doctor-patient relationship.</p> </sec> <sec> <title>OBJECTIVE</title> <p>Our aim was to evaluate the effectiveness of digital education in medical students for communication skills development. Broadly, we assessed whether digital education could improve the quality of future doctors’ communication skills.</p> </sec> <sec> <title>METHODS</title> <p>We performed a systematic review and searched seven electronic databases and two trial registries for randomized controlled trials (RCTs) and cluster RCTs (cRCTs) published between January 1990 and September 2018. Two reviewers independently screened the citations, extracted data from the included studies, and assessed the risk of bias. We also assessed the quality of evidence using the Grading of Recommendations, Assessment, Development, and Evaluations assessment (GRADE).</p> </sec> <sec> <title>RESULTS</title> <p>We included 12 studies with 2101 medical students, of which 10 were RCTs and two were cRCTs. The digital education included online modules, virtual patient simulations, and video-assisted oral feedback. The control groups included didactic lectures, oral feedback, standard curriculum, role play, and no intervention as well as less interactive forms of digital education. The overall risk of bias was high, and the quality of evidence ranged from moderate to very low. For skills outcome, meta-analysis of three studies comparing digital educat
Bajpai S, Semwal M, Bajpai R, et al., 2018, Health Professions’ Digital Education: Review of Learning Theories in Randomized Controlled Trials by the Digital Health Education Collaboration (Preprint)
<sec> <title>BACKGROUND</title> <p>Learning theory is an essential component for designing an effective educational curriculum. Reviews of existing literature consistently lack sufficient evidence to support the effectiveness of digital interventions for health professions’ education, which may reflect disconnections among learning theories, curriculum design, use of technology, and outcome evaluation.</p> </sec> <sec> <title>OBJECTIVE</title> <p>The aim of this review was to identify, map, and evaluate the use of learning theories in designing and implementing intervention trials of health professions’ digital education, as well as highlight areas for future research on technology-enhanced education via the establishment of a development framework for practice and research.</p> </sec> <sec> <title>METHODS</title> <p>We performed a systematic search of Medical Literature Analysis and Retrieval System Online, Excerpta Medica database, Cochrane Central Register of Controlled Trials (Cochrane Library), PsycINFO, Cumulative Index to Nursing and Allied Health Literature, Education Resources Information Center, and Web of Science for randomized controlled trials (RCTs) published between 2007 and 2016.</p> </sec> <sec> <title>RESULTS</title> <p>A total of 874 RCTs on digital health education were identified and categorized into online-offline, mobile digital education, and simulation-based modalities for pre and postregistration health professions’ education. Of these, 242 studies were randomly selected for methodological rev
Meinert E, Van Velthoven M, Brindley D, et al., 2018, The internet of things in health care in Oxford: protocol for proof-of-concept projects, JMIR Research Protocols, Vol: 7, Pages: 1-12, ISSN: 1929-0748
Background:Demands on health services across are increasing because of the combined challenges of an expanding and aging population, alongside complex comorbidities that transcend the classical boundaries of modern health care. Continuing to provide and coordinate care in the current manner is not a viable route to sustain the improvements in health outcomes observed in recent history. To ensure that there continues to be improvement in patient care, prevention of disease, and reduced burden on health systems, it is essential that we adapt our models of delivery. Providers of health and social care are evolving to face these pressures by changing the way they think about the care system and, importantly, how to involve patients in the planning and delivery of services.Objective:The objective of this paper is to provide (1) an overview of the current state of Internet of Things (IoT) and key implementation considerations, (2) key use cases demonstrating technology capabilities, (3) an overview of the landscape for health care IoT use in Oxford, and (4) recommendations for promoting the IoT via collaborations between higher education institutions and industry proof-of-concept (PoC) projects.Methods:This study describes the PoC projects that will be created to explore cost-effectiveness, clinical efficacy, and user adoption of Internet of Medical Things systems. The projects will focus on 3 areas: (1) bring your own device integration, (2) chronic disease management, and (3) personal health records.Results:This study is funded by Research England’s Connecting Capability Fund. The study started in March 2018, and results are expected by the end of 2019.Conclusions:Embracing digital solutions to support the evolution and transformation of health services is essential. Importantly, this should not simply be undertaken by providers in isolation. It must embrace and exploit the advances being seen in the consumer devices, national rollout of high-speed broadband servi
George PP, Ooi CK, Leong E, et al., 2018, Return on investment in blended advanced cardiac life support training compared to face-to-face training in Singapore, PROCEEDINGS OF SINGAPORE HEALTHCARE, Vol: 27, Pages: 234-242, ISSN: 2010-1058
Gentry SV, Gauthier A, L'Estrade Ehrstrom B, et al., 2018, Serious Gaming and Gamification Education in Health Professions: Systematic Review (Preprint)
<sec> <title>BACKGROUND</title> <p>There is a worldwide shortage of health workers, and this issue requires innovative education solutions. Serious gaming and gamification education have the potential to provide a quality, cost-effective, novel approach that is flexible, portable, and enjoyable and allow interaction with tutors and peers.</p> </sec> <sec> <title>OBJECTIVE</title> <p>The aim of this systematic review was to evaluate the effectiveness of serious gaming/gamification for health professions education compared with traditional learning, other types of digital education, or other serious gaming/gamification interventions in terms of patient outcomes, knowledge, skills, professional attitudes, and satisfaction (primary outcomes) as well as economic outcomes of education and adverse events (secondary outcomes).</p> </sec> <sec> <title>METHODS</title> <p>A comprehensive search of MEDLINE, EMBASE, Web of Knowledge, Educational Resources Information Centre, Cochrane Central Register of Controlled Trials, PsycINFO, and Cumulative Index to Nursing and Allied Health Literature was conducted from 1990 to August 2017. Randomized controlled trials (RCTs) and cluster RCTs were eligible for inclusion. Two reviewers independently searched, screened, and assessed the study quality and extracted data. A meta-analysis was not deemed appropriate due to the heterogeneity of populations, interventions, comparisons, and outcomes. Therefore, a narrative synthesis is presented.</p> </sec> <sec> <title>RESULTS</title> <p>A total of 27 RCTs and 3 clus
Posadzki P, Bala MM, Kyaw BM, et al., 2018, Offline Digital Education for Postregistration Health Professions: Systematic Review and Meta-Analysis by the Digital Health Education Collaboration (Preprint)
<sec> <title>BACKGROUND</title> <p>The shortage and disproportionate distribution of health care workers worldwide is further aggravated by the inadequacy of training programs, difficulties in implementing conventional curricula, deficiencies in learning infrastructure, or a lack of essential equipment. Offline digital education has the potential to improve the quality of health professions education.</p> </sec> <sec> <title>OBJECTIVE</title> <p>The primary objective of this systematic review was to evaluate the effectiveness of offline digital education compared with various controls in improving learners’ knowledge, skills, attitudes, satisfaction, and patient-related outcomes. The secondary objectives were (1) to assess the cost-effectiveness of the interventions and (2) to assess adverse effects of the interventions on patients and learners.</p> </sec> <sec> <title>METHODS</title> <p>We searched 7 electronic databases and 2 trial registries for randomized controlled trials published between January 1990 and August 2017. We used Cochrane systematic review methods.</p> </sec> <sec> <title>RESULTS</title> <p>A total of 27 trials involving 4618 individuals were included in this systematic review. Meta-analyses found that compared with no intervention, offline digital education (CD-ROM) may increase knowledge in nurses (standardized mean difference [SMD]=1.88; 95% CI 1.14 to 2.62; participants=300; studies=3; I2=80%; low certainty evidence). A meta-analysis of 2 studies found that compared with no intervention, the effects of offli
Car J, Carlstedt-Duke J, Tudor Car L, et al., 2018, Digital education in health professions: the need for overarching rvidence synthesis (Preprint), Publisher: JMIR Publications Inc.
Synthesizing evidence from randomized controlled trials of digital health education poses some challenges. These include a lack of clear categorization of digital health education in the literature; constantly evolving concepts, pedagogies, or theories; and a multitude of methods, features, technologies, or delivery settings. The Digital Health Education Collaboration was established to evaluate the evidence on digital education in health professions; inform policymakers, educators, and students; and ultimately, change the way in which these professionals learn and are taught. The aim of this paper is to present the overarching methodology that we use to synthesize evidence across our digital health education reviews and to discuss challenges related to the process. For our research, we followed Cochrane recommendations for the conduct of systematic reviews; all reviews are reported according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidance. This included assembling experts in various digital health education fields; identifying gaps in the evidence base; formulating focused research questions, aims, and outcome measures; choosing appropriate search terms and databases; defining inclusion and exclusion criteria; running the searches jointly with librarians and information specialists; managing abstracts; retrieving full-text versions of papers; extracting and storing large datasets, critically appraising the quality of studies; analyzing data; discussing findings; drawing meaningful conclusions; and drafting research papers. The approach used for synthesizing evidence from digital health education trials is commonly regarded as the most rigorous benchmark for conducting systematic reviews. Although we acknowledge the presence of certain biases ingrained in the process, we have clearly highlighted and minimized those biases by strictly adhering to scientific rigor, methodological integrity, and standard operating procedures.
Doherty K, Barry M, Marcano-Belisario J, et al., 2018, A Mobile App for the Self-Report of Psychological Well-Being During Pregnancy (BrightSelf): Qualitative Design Study, JMIR MENTAL HEALTH, Vol: 5, ISSN: 2368-7959
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- Citations: 18
Lall P, Rees R, Law GCY, et al., 2018, Influences on the Implementation of Mobile Learning for Medical and Nursing Education: Qualitative Systematic Review by the Digital Health Education Collaboration (Preprint)
<sec> <title>BACKGROUND</title> <p>In the past 5 decades, digital education has increasingly been used in health professional education. Mobile learning (mLearning), an emerging form of educational technology using mobile devices, has been used to supplement learning outcomes through enabling conversations, sharing information and knowledge with other learners, and aiding support from peers and instructors regardless of geographic distance.</p> </sec> <sec> <title>OBJECTIVE</title> <p>This review aimed to synthesize findings from qualitative or mixed-methods studies to provide insight into factors facilitating or hindering implementation of mLearning strategies for medical and nursing education.</p> </sec> <sec> <title>METHODS</title> <p>A systematic search was conducted across a range of databases. Studies with the following criteria were selected: examined mLearning in medical and nursing education, employed a mixed-methods or qualitative approach, and published in English after 1994. Findings were synthesized using a framework approach.</p> </sec> <sec> <title>RESULTS</title> <p>A total of 1946 citations were screened, resulting in 47 studies being selected for inclusion. Most studies evaluated pilot mLearning interventions. The synthesis identified views on valued aspects of mobile devices in terms of efficiency and personalization but concerns over vigilance and poor device functionality; emphasis on the social aspects of technology, especially in a clinical setting; the value of interaction learning for clinical practice; mLearnin
James SL, 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, The Lancet, Vol: 392, Pages: 1789-1858, ISSN: 0140-6736
BackgroundThe Global Burden of Diseases, Injuries, and Risk Factors Study 2017 (GBD 2017) includes a comprehensive assessment of incidence, prevalence, and years lived with disability (YLDs) for 354 causes in 195 countries and territories from 1990 to 2017. Previous GBD studies have shown how the decline of mortality rates from 1990 to 2016 has led to an increase in life expectancy, an ageing global population, and an expansion of the non-fatal burden of disease and injury. These studies have also shown how a substantial portion of the world's population experiences non-fatal health loss with considerable heterogeneity among different causes, locations, ages, and sexes. Ongoing objectives of the GBD study include increasing the level of estimation detail, improving analytical strategies, and increasing the amount of high-quality data.MethodsWe estimated incidence and prevalence for 354 diseases and injuries and 3484 sequelae. We used an updated and extensive body of literature studies, survey data, surveillance data, inpatient admission records, outpatient visit records, and health insurance claims, and additionally used results from cause of death models to inform estimates using a total of 68 781 data sources. Newly available clinical data from India, Iran, Japan, Jordan, Nepal, China, Brazil, Norway, and Italy were incorporated, as well as updated claims data from the USA and new claims data from Taiwan (province of China) and Singapore. We used DisMod-MR 2.1, a Bayesian meta-regression tool, as the main method of estimation, ensuring consistency between rates of incidence, prevalence, remission, and cause of death for each condition. YLDs were estimated as the product of a prevalence estimate and a disability weight for health states of each mutually exclusive sequela, adjusted for comorbidity. We updated the Socio-demographic Index (SDI), a summary development indicator of income per capita, years of schooling, and total fertility rate. Additionally, we calcula
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, The Lancet, Vol: 392, Pages: 2091-2138, ISSN: 0140-6736
BackgroundEfforts to establish the 2015 baseline and monitor early implementation of the UN Sustainable Development Goals (SDGs) highlight both great potential for and threats to improving health by 2030. To fully deliver on the SDG aim of “leaving no one behind”, it is increasingly important to examine the health-related SDGs beyond national-level estimates. As part of the Global Burden of Diseases, Injuries, and Risk Factors Study 2017 (GBD 2017), we measured progress on 41 of 52 health-related SDG indicators and estimated the health-related SDG index for 195 countries and territories for the period 1990–2017, projected indicators to 2030, and analysed global attainment.MethodsWe measured progress on 41 health-related SDG indicators from 1990 to 2017, an increase of four indicators since GBD 2016 (new indicators were health worker density, sexual violence by non-intimate partners, population census status, and prevalence of physical and sexual violence [reported separately]). We also improved the measurement of several previously reported indicators. We constructed national-level estimates and, for a subset of health-related SDGs, examined indicator-level differences by sex and Socio-demographic Index (SDI) quintile. We also did subnational assessments of performance for selected countries. To construct the health-related SDG index, we transformed the value for each indicator on a scale of 0–100, with 0 as the 2·5th percentile and 100 as the 97·5th percentile of 1000 draws calculated from 1990 to 2030, and took the geometric mean of the scaled indicators by target. To generate projections through 2030, we used a forecasting framework that drew estimates from the broader GBD study and used weighted averages of indicator-specific and country-specific annualised rates of change from 1990 to 2017 to inform future estimates. We assessed attainment of indicators with defined targets in two ways: first, using mean values projected fo
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, The Lancet, Vol: 392, Pages: 1647-1661, ISSN: 0140-6736
BackgroundPrevious studies have reported national and regional Global Burden of Disease (GBD) estimates for the UK. Because of substantial variation in health within the UK, action to improve it requires comparable estimates of disease burden and risks at country and local levels. The slowdown in the rate of improvement in life expectancy requires further investigation. We use GBD 2016 data on mortality, causes of death, and disability to analyse the burden of disease in the countries of the UK and within local authorities in England by deprivation quintile.MethodsWe extracted data from the GBD 2016 to estimate years of life lost (YLLs), years lived with disability (YLDs), disability-adjusted life-years (DALYs), and attributable risks from 1990 to 2016 for England, Scotland, Wales, Northern Ireland, the UK, and 150 English Upper-Tier Local Authorities. We estimated the burden of disease by cause of death, condition, year, and sex. We analysed the association between burden of disease and socioeconomic deprivation using the Index of Multiple Deprivation. We present results for all 264 GBD causes of death combined and the leading 20 specific causes, and all 84 GBD risks or risk clusters combined and 17 specific risks or risk clusters.FindingsThe leading causes of age-adjusted YLLs in all UK countries in 2016 were ischaemic heart disease, lung cancers, cerebrovascular disease, and chronic obstructive pulmonary disease. Age-standardised rates of YLLs for all causes varied by two times between local areas in England according to levels of socioeconomic deprivation (from 14 274 per 100 000 population [95% uncertainty interval 12 791–15 875] in Blackpool to 6888 [6145–7739] in Wokingham). Some Upper-Tier Local Authorities, particularly those in London, did better than expected for their level of deprivation. Allowing for differences in age structure, more deprived Upper-Tier Local Authorities had higher attributable YLLs for most major risk factors in the GBD.
Tan WS, Bajpai R, Low CK, et al., 2018, Using routinely collected data to ascertain concordance with advance care planning preferences, Journal of Pain and Symptom Management, Vol: 56, Pages: 659-666.e2, ISSN: 0885-3924
BACKGROUND: One of the key outcomes of Advance Care Planning (ACP) is whether patients had received care that was consistent with their expressed goals and preferences. AIM: To illustrate the feasibility of using routinely collected healthcare data that includes hospital procedural codes, diagnosis-related codes, health services utilisation and death registry data, to ascertain the level of concordance between care received and the stated goals. DESIGN: In this retrospective cohort study, medical treatments were ascertained using a combination of hospital procedural codes, and diagnosis-related codes. Places of care were obtained by reviewing the sequence of health services utilised, and the place of death was obtained from the national death registry. To ascertain concordance, medical treatment, places of care, and place of death, were compared against the individual's preferences. RESULTS: The sample include 1,731 decedents (aged 21 years and above) who completed their ACP documentation as part of a national programme. Ninety-eight percent who wished for comfort measures met their preferences. Sixty-five percent of individuals who wished to be cared for at home received care at home. Nearly 40% of all individuals who opted to die at home achieved their wishes; whereas 76% of those who opted for home or hospital and home or hospice had their preferences fulfilled. CONCLUSION: Administrative data offer a cost-efficient and powerful method for assessing outcomes for a large population-based national programme. However, this approach is still at an early stage of development, and needs to be further validated before it can be used at scale.
Bowman L, Mafham M, Wallendszus K, et al., 2018, Effects of n-3 Fatty Acid Supplements in Diabetes Mellitus, NEW ENGLAND JOURNAL OF MEDICINE, Vol: 379, Pages: 1540-1550, ISSN: 0028-4793
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- Citations: 421
Bowman L, Mafham M, Wallendszus K, et al., 2018, Effects of Aspirin for Primary Prevention in Persons with Diabetes Mellitus, NEW ENGLAND JOURNAL OF MEDICINE, Vol: 379, Pages: 1529-1539, ISSN: 0028-4793
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- Citations: 651
Meinert E, Alturkistani A, Car J, et al., 2018, Real-world evidence for postgraduate students and professionals in healthcare: protocol for the design of a blended massive open online course, BMJ Open, Vol: 8, Pages: 1-5, ISSN: 2044-6055
Introduction:There is an increased need for improving data science skills of healthcare professionals. MassiveOpen Online Courses (MOOCs) provide the opportunity to train professionals in a sustainable andcost-effective way. We present a protocol for the design and development of a blended MOOC onRWE aimed at improving RWE data science skills. The primary objective is to provide the opportunityto understand the fundamentals of RWE data science and to implement methods for analysing RWD.The blended format of the MOOC will combine the expertise of healthcare professionals joining thecourse online with the students on-campus. We expect learners to take skills taught in the MOOCand use them to seek new employment or start to initiatives in these domains.Methods and Analysis:The proposed MOOC will be developed through a blended format using the ADDIE (Analysis, Design,Development, Implementation and Evaluation) instructional design model and following theconnectivist-heutagogical learning theories (as a hybrid MOOC). The target learners will includepostgraduate students and professionals working in the health-related roles with interest in datascience. An evaluation of the MOOC will be performed to assess the MOOCs success in meeting itsintended outcomes and to improve future iterations of the course.Ethics and dissemination:The education course design protocol was approved by EIT Health (Grant 18654) as part of the EITHealth CAMPUS Deferred Call for Innovative Education 2018. Results will be published in a peerreviewedjournal.
Alturkistani A, Majeed F, 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
Introduction The use of health information technologies (HITs) has been associated with positive benefits such as improved health outcomes and improved health services. Results from empirical studies reported potential benefits of HITs in preventive medicine measures such as primary prevention. This review will examine the broad range of HITs and their uses and effectiveness in primary prevention.Methods and analysis We will conduct searches in relevant databases (MEDLINE, EMBASE, the Cochrane Methodology Register, Cochrane Database of Systematic Reviews, CINAHL, SCOPUS and Web of Science) using Arksey and O’Malley’s scoping review methodology. The scoping review will include all study designs to identify the literature on HIT uses. Two reviewers will independently screen the literature following our screening criteria and using a data abstraction form. Findings will be summarised quantitatively (using numerical counts of HITs) and qualitatively (using narrative synthesis).Ethics and dissemination The study will synthesise data from published literature and will not require an ethical approval. The results of the review will be disseminated through a peer-reviewed journal.
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