Publications
47 results found
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.
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
Meinert E, Van Velthoven M, Brindley D, et al., 2018, The internet of things in healthcare: proof of concept opportunities in Oxford, JMIR Research Protocols, Vol: 7, ISSN: 1929-0748
BackgroundDemands on health services across the globe are increasing due to the combined challenges of an expanding and ageing population, alongside complex comorbidities that transcend the classical boundaries of modern healthcare. To meet these challenges, we must increase the quality of care, and the efficiency with which it is delivered. Continuing to provide and coordinate care in the current manner is not a viable route to sustaining 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 healthcare 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.ObjectivesThe objective of this paper is to provide: 1. An overview of the current state of IoT and key implementation considerations2. Key use cases demonstrating technology capabilities3. Overview of the landscape for healthcare Internet of Things use in Oxford4. Recommendations for PITCH-In proof of concept projectsMethodsThis paper describes the proof-of-concept (PoC) projects that will be created to explore both cost effectiveness, clinical efficacy and user adoption of IoMT systems. The projects will focus on three areas: 1) Bring your own device (BYOD) Integration, 2) Chronic Disease Management and 3) Personal Health Records. ResultsThis project is funded by Research England’s Connecting Capability (CCF) fund. The project started on March 2018 and results are expected by the end of 2019. ConclusionsEmbracing 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 o
Foley KA, Groome PA, Peng Y, et al., 2018, Identifying priorities for improvement of the quality of personal care in patients undergoing radiotherapy for prostate cancer, European Journal for Person Centered Healthcare, Vol: 6, Pages: 621-621, ISSN: 2052-5648
<jats:p>Background: We previously developed a questionnaire to assess the quality of personal care in prostate cancer radiotherapy. Patients are asked to rate the importance of 143 elements of their care and to rate the quality of their care for each element. In order to improve the quality of care delivered to patients, the elements of care most in need of improvement must be identified.Objective: To develop a method of integrating ratings of importance and ratings of quality to identify elements of care that should become targets for quality improvement.Methods: We surveyed 108 patients undergoing radiotherapy for prostate cancer. We developed 3 methods to identify elements of care to target for quality improvement that were important to the patient(s) and suboptimal in quality. Spearman correlation was used to compare ranking of priorities across all 3 methods. Generalized estimating equations were used to assess the statistical ability of the methods to discriminate between priorities for quality improvement.Results: Integrating importance and quality ratings identified different priorities than using quality ratings alone. Two of the integrated methods identified priorities for quality improvement and their ranks similarly (r=0.91, p<0.0001). All methods identified elements related to communication of information about the disease and its treatment as priorities.Conclusions: Two methods produced similar results although one is easier to understand and theoretically superior since the ratings for importance and quality are linked for each individual. Further consultation with stakeholders will determine how to use these results as part of a quality improvement program.</jats:p>
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 (Preprint), Publisher: JMIR Publications
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
Foley K, Alturkistani A, Carter A, et al., 2018, Massive Open Online Courses (MOOC) evaluation methods: protocol for a systematic review (preprint), Publisher: JMIR Publications
Background: 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.Objective: The purpose of this paper is to provide a protocol for a systematic review on MOOC evaluation methods.Methods: We will use the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA-P) guidelines for reporting this protocol. We developed a population, intervention, comparator, and outcome (PICO) framework to guide the search strategy, based on the overarching question, “What methods have been used to evaluate MOOCs?” The review will follow six stages: 1) literature search, 2) article selection, 3) data extraction, 4) quality appraisal, 5) data analysis, and 6) data synthesis.Results: The systematic review is ongoing. We completed the data searches and data abstraction in October and November 2018. We are now analyzing the data and expect to complete the systematic review by March 2019.Conclusions: This systematic review will provide a useful summary of the methods used for evaluation of MOOCs and the strengths and limitations of each approach. It will also identify gaps in the literature and areas for future work.
Majeed FA, Allwood D, Foley K, et al., 2018, Healthcare outcomes and quality in the NHS: how do we compare and how might the NHS improve?, BMJ, Vol: 362, ISSN: 0959-8138
Health outcomes in the United Kingdom have improved substantially since the NHS was established in 1948.1 For example, average life expectancy has increased by around 12 years from 68 to 80 years; and infant mortality has fallen nearly 90%, from 34/1000 live births to less than 4/1000.2 The NHS performs well in many international comparisons on measures such as efficiency, equity, and access.3 Despite these achievements, however, problems with health outcomes remain.34 Moreover, other European countries have also improved their health outcomes in recent decades, often at a faster rate than the UK. Consequently, the UK now lags behind many other European countries in key health outcomes in areas such as child health and cancer survival. Here, we review the quality of care and health outcomes in the NHS, focusing on areas that are important to patients, policy makers, and clinicians4 and for which there are comparative international data.
Meinert E, Alturkistani A, Foley KA, et al., 2018, Blockchain implementation in health care: protocol for a systematic review (Preprint), Publisher: JMIR Publications Inc.
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 framewor
Foley KA, Groome PA, Feldman-Stewart D, et al., 2017, Measuring the Quality of Personal Care in Patients Undergoing Radiotherapy for Prostate Cancer, CLINICAL ONCOLOGY, Vol: 29, Pages: 827-834, ISSN: 0936-6555
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- Citations: 1
Foley K, Groome P, Feldman-Stewart D, et al., 2016, Measuring the Quality of Personal Care in Patients Undergoing Radiation Therapy for Prostate Cancer, INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS, Vol: 96, Pages: E257-E257, ISSN: 0360-3016
Greenfield G, Foley K, Majeed A, 2016, Rethinking primary care's gatekeeper role., BMJ, Vol: 354, ISSN: 0959-8138
Gatekeeping is the term used to describe the role of primary care physicians or general practitioners (GPs) in authorising access to specialty care, hospital care, and diagnostic tests.1 Gatekeeping has crucial influences on service utilisation, health outcomes, healthcare costs, and patient satisfaction.In the UK access to NHS and private specialists is generally possible only after a referral from a GP. Gatekeeping was developed as a response to a shortage of specialists and a desire to control healthcare spending2 and has been an accepted practice in the UK for over 100 years.3 The NHS is under considerable pressure to use its resources efficiently, and primary care has helped the NHS to achieve this goal through its gatekeeping function.4 Yet direct access could help reduce GP workload and facilitate greater patient choice. We look at the pros and cons of gatekeeping, describe gatekeeping policies in various countries, and highlight the need for more evidence to devise policy.
Foley JH, Walton BL, Aleman MM, et al., 2016, Complement Activation in Arterial and Venous Thrombosis is Mediated by Plasmin, EBIOMEDICINE, Vol: 5, Pages: 175-182, ISSN: 2352-3964
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- Citations: 90
Foley KA, Feldman-Stewart D, Groome PA, et al., 2016, What Aspects of Personal Care Are Most Important to Patients Undergoing Radiation Therapy for Prostate Cancer?, INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS, Vol: 94, Pages: 280-288, ISSN: 0360-3016
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- Citations: 6
Foley K, Groome P, Feldman-Stewart D, et al., 2015, Measuring the quality of personal care in prostate cancer radiotherapy, EUROPEAN JOURNAL OF CANCER, Vol: 51, Pages: S485-S485, ISSN: 0959-8049
Foley K, Feldman-Stewart D, Brundage M, et al., 2014, Measuring the Quality of Personal Care in Prostate Cancer Radiation Therapy: What Aspects of Care Are Important to Patients?, INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS, Vol: 90, Pages: S582-S583, ISSN: 0360-3016
Brundage M, Bass B, Jolie R, et al., 2011, A knowledge translation challenge: clinical use of quality of life data from cancer clinical trials, QUALITY OF LIFE RESEARCH, Vol: 20, Pages: 979-985, ISSN: 0962-9343
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- Citations: 39
Danielson B, Brundage M, Pearcey R, et al., 2011, Development of indicators of the quality of radiotherapy for localized prostate cancer, RADIOTHERAPY AND ONCOLOGY, Vol: 99, Pages: 29-36, ISSN: 0167-8140
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- Citations: 24
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