Imperial College London

ProfessorRifatAtun

Faculty of MedicineDepartment of Infectious Disease

Visiting Professor
 
 
 
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Contact

 

+44 (0)20 7594 9160r.atun Website

 
 
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Location

 

289aBusiness School BuildingSouth Kensington Campus

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Summary

 

Publications

Publication Type
Year
to

582 results found

Geldsetzer P, Tisdale RL, Stehr L, Michalik F, Lemp J, Aryal KK, Damasceno A, Houehanou C, Jørgensen JMA, Lunet N, Mayige M, Saeedi Moghaddam S, Mwangi KJ, Bommer C, Marcus M-E, Theilmann M, Ebert C, Atun R, Davies JI, Flood D, Manne-Goehler J, Seiglie J, Bärnighausen T, Vollmer Set al., 2024, The prevalence of cardiovascular disease risk factors among adults living in extreme poverty., Nat Hum Behav

Evidence on cardiovascular disease (CVD) risk factor prevalence among adults living below the World Bank's international line for extreme poverty (those with income <$1.90 per day) globally is sparse. Here we pooled individual-level data from 105 nationally representative household surveys across 78 countries, representing 85% of people living in extreme poverty globally, and sorted individuals by country-specific measures of household income or wealth to identify those in extreme poverty. CVD risk factors (hypertension, diabetes, smoking, obesity and dyslipidaemia) were present among 17.5% (95% confidence interval (CI) 16.7-18.3%), 4.0% (95% CI 3.6-4.5%), 10.6% (95% CI 9.0-12.3%), 3.1% (95% CI 2.8-3.3%) and 1.4% (95% CI 0.9-1.9%) of adults in extreme poverty, respectively. Most were not treated for CVD-related conditions (for example, among those with hypertension earning <$1.90 per day, 15.2% (95% CI 13.3-17.1%) reported taking blood pressure-lowering medication). The main limitation of the study is likely measurement error of poverty level and CVD risk factors that could have led to an overestimation of CVD risk factor prevalence among adults in extreme poverty. Nonetheless, our results could inform equity discussions for resource allocation and design of effective interventions.

Journal article

Stein DT, Reitsma MB, Geldsetzer P, Agoudavi K, Aryal KK, Bahendeka S, Brant LCC, Farzadfar F, Gurung MS, Guwatudde D, Houehanou YCN, Malta DC, Martins JS, Saeedi Moghaddam S, Mwangi KJ, Norov B, Sturua L, Zhumadilov Z, Bärnighausen T, Davies JI, Flood D, Marcus ME, Theilmann M, Vollmer S, Manne-Goehler J, Atun R, Sudharsanan N, Verguet Set al., 2024, Hypertension care cascades and reducing inequities in cardiovascular disease in low- and middle-income countries., Nat Med, Vol: 30, Pages: 414-423

Improving hypertension control in low- and middle-income countries has uncertain implications across socioeconomic groups. In this study, we simulated improvements in the hypertension care cascade and evaluated the distributional benefits across wealth quintiles in 44 low- and middle-income countries using individual-level data from nationally representative, cross-sectional surveys. We raised diagnosis (diagnosis scenario) and treatment (treatment scenario) levels for all wealth quintiles to match the best-performing country quintile and estimated the change in 10-year cardiovascular disease (CVD) risk of individuals initiated on treatment. We observed greater health benefits among bottom wealth quintiles in middle-income countries and in countries with larger baseline disparities in hypertension management. Lower-middle-income countries would see the greatest absolute benefits among the bottom quintiles under the treatment scenario (29.1 CVD cases averted per 1,000 people living with hypertension in the bottom quintile (Q1) versus 17.2 in the top quintile (Q5)), and the proportion of total CVD cases averted would be largest among the lowest quintiles in upper-middle-income countries under both diagnosis (32.0% of averted cases in Q1 versus 11.9% in Q5) and treatment (29.7% of averted cases in Q1 versus 14.0% in Q5) scenarios. Targeted improvements in hypertension diagnosis and treatment could substantially reduce socioeconomic-based inequalities in CVD burden in low- and middle-income countries.

Journal article

Martinengo L, Lin X, Jabir AI, Kowatsch T, Atun R, Car J, Tudor Car Let al., 2023, Conversational Agents in Health Care: Expert Interviews to Inform the Definition, Classification, and Conceptual Framework., J Med Internet Res, Vol: 25

BACKGROUND: Conversational agents (CAs), or chatbots, are computer programs that simulate conversations with humans. The use of CAs in health care settings is recent and rapidly increasing, which often translates to poor reporting of the CA development and evaluation processes and unreliable research findings. We developed and published a conceptual framework, designing, developing, evaluating, and implementing a smartphone-delivered, rule-based conversational agent (DISCOVER), consisting of 3 iterative stages of CA design, development, and evaluation and implementation, complemented by 2 cross-cutting themes (user-centered design and data privacy and security). OBJECTIVE: This study aims to perform in-depth, semistructured interviews with multidisciplinary experts in health care CAs to share their views on the definition and classification of health care CAs and evaluate and validate the DISCOVER conceptual framework. METHODS: We conducted one-on-one semistructured interviews via Zoom (Zoom Video Communications) with 12 multidisciplinary CA experts using an interview guide based on our framework. The interviews were audio recorded, transcribed by the research team, and analyzed using thematic analysis. RESULTS: Following participants' input, we defined CAs as digital interfaces that use natural language to engage in a synchronous dialogue using ≥1 communication modality, such as text, voice, images, or video. CAs were classified by 13 categories: response generation method, input and output modalities, CA purpose, deployment platform, CA development modality, appearance, length of interaction, type of CA-user interaction, dialogue initiation, communication style, CA personality, human support, and type of health care intervention. Experts considered that the conceptual framework could be adapted for artificial intelligence-based CAs. However, despite recent advances in artificial intelligence, including large language models, the technology is not able to ensure

Journal article

Lin X, Martinengo L, Jabir AI, Ho AHY, Car J, Atun R, Car LTet al., 2023, Scope, Characteristics, Behavior Change Techniques, and Quality of Conversational Agents for Mental Health and Well-Being: Systematic Assessment of Apps, JOURNAL OF MEDICAL INTERNET RESEARCH, Vol: 25, ISSN: 1438-8871

Journal article

Ward ZJ, Atun R, King G, Dmello BS, Goldie SJet al., 2023, A simulation-based comparative effectiveness analysis of policies to improve global maternal health outcomes, NATURE MEDICINE, Vol: 29, Pages: 1262-+, ISSN: 1078-8956

Journal article

Ward ZJ, Atun R, King G, Sequeira Dmello B, Goldie SJet al., 2023, Simulation-based estimates and projections of global, regional and country-level maternal mortality by cause, 1990-2050, NATURE MEDICINE, Vol: 29, Pages: 1253-+, ISSN: 1078-8956

Journal article

Palladino R, pan T, mercer S, Atun R, mcpake B, rubba F, triassi M, Lee Tet al., 2023, Multimorbidity and out-of-pocket expenditure on medicine in Europe: longitudinal analysis of 13 European countries between 2013-2015, Frontiers in Public Health, Vol: 10, Pages: 1-12, ISSN: 2296-2565

Background: Many European Health Systems are implementing or increasing levels of cost-sharing for medicine in response to the growing constrains on public spending on health despite their negative impact on population health due to delay in seeking care.Objective: This study aims to examine the relationships between multimorbidity (two or more coexisting chronic diseases, CDs), complex multimorbidity (three or more CDs impacting at least three different body systems), and out-of-pocket expenditure (OOPE) for medicine across European nations.Methods: This study utilized data on participants aged 50 years and above from two recent waves of the Survey of Health, Aging, and Retirement in Europe conducted in 2013 (n = 55,806) and 2015 (n = 51,237). Pooled cross-sectional and longitudinal study designs were used, as well as a two-part model, to analyse the association between multimorbidity and OOPE for medicine.Results: The prevalence of multimorbidity was 50.4% in 2013 and 48.2% in 2015. Nearly half of those with multimorbidity had complex multimorbidity. Each additional CD was associated with a 34% greater likelihood of incurring any OOPE for medicine (Odds ratio = 1.34, 95% CI = 1.31–1.36). The average incremental OOPE for medicine was 26.4 euros for each additional CD (95% CI = 25.1–27·7), and 32.1 euros for each additional body system affected (95% CI 30.6–33.7). In stratified analyses for country-specific quartiles of household income the average incremental OOPE for medicine was not significantly different across groups.Conclusion: Between 2013 and 2015 in 13 European Health Systems increased prevalence of CDs was associated with greater likelihood of having OOPE on medication and an increase in the average amount spent when one occurred. Monitoring this indicator is important considering the negative association with treatment adherence and subsequent effects on health.

Journal article

Marques T, Cezario S, Lacerda J, Pinto R, Silva L, Santana O, Ribeiro AG, Cruz AS, Miranda AE, Cadaxa A, Nunez LS, Oliveira HG, Atun R, Valentim Ret al., 2022, Sentiment Analysis in Understanding the Potential of Online News in the Public Health Crisis Response, INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH, Vol: 19

Journal article

Silva S, Ayoub HH, Johnston C, Atun R, Abu-Raddad LJet al., 2022, Estimated economic burden of genital herpes and HIV attributable to herpes simplex virus type 2 infections in 90 low- and middle-income countries: A modeling study, PLOS MEDICINE, Vol: 19, ISSN: 1549-1277

Journal article

Ward ZJ, Yeh JM, Reddy CL, Gomber A, Ross C, Rittiphairoj T, Manne-Goehler J, Abdalla AT, Abdullah MA, Ahmed A, Ankotche A, Azad K, Bahendeka S, Balde N, Jain SM, Kalobu JC, Karekezi C, Kol H, Prasannakumar KM, Leik SK, Mbanya JC, Mbaye MN, Niang B, Paturi VR, Raghupathy P, Ramaiya K, Sethi B, Zabeen B, Atun Ret al., 2022, Estimating the total incidence of type 1 diabetes in children and adolescents aged 0-19 years from 1990 to 2050: a global simulation-based analysis, LANCET DIABETES & ENDOCRINOLOGY, Vol: 10, Pages: 848-858, ISSN: 2213-8587

Journal article

Manne-Goehler J, Theilmann M, Flood D, Marcus ME, Andall-Brereton G, Agoudavi K, Arboleda WAL, Aryal KK, Bicaba B, Bovet P, Caldeira Brant LC, Brian G, Chamberlin G, Chen G, Damasceno A, Dorobantu M, Dunn M, Ebert C, Farzadfar F, Gurung MS, Guwatudde D, Houehanou C, Houinato D, Hwalla N, Jorgensen JMA, Karki KB, Labadarios D, Lunet N, Malta DC, Martins JS, Mayige MT, McClure RW, Moghaddam SS, Mwangi KJ, Mwalim O, Norov B, Quesnel-Crooks S, Rhode S, Seiglie JA, Sibai A, Silver BK, Sturua L, Stokes A, Supiyev A, Tsabedze L, Zhumadilov Z, Jaacks LM, Atun R, Davies J, Geldsetzer P, Vollmer S, Baernighausen TWet al., 2022, Data Resource Profile: The Global Health and Population Project on Access to Care for Cardiometabolic Diseases (HPACC), INTERNATIONAL JOURNAL OF EPIDEMIOLOGY, Vol: 51, Pages: E337-E349, ISSN: 0300-5771

Journal article

Tuan Vu La D, Zhao Y, Arokiasamy P, Atun R, Mercer SW, Marthias T, McPake B, Pati S, Palladino R, Lee TYet al., 2022, Multimorbidity and out-of-pocket expenditure for medicines in China and India, BMJ Global Health, Vol: 7, ISSN: 2059-7908

Introduction: Using nationally representative survey data from China and India, this study examined (1) the distribution and patterns of multimorbidity in relation to socioeconomic status and (2) association between multimorbidity and out-of-pocket expenditure (OOPE) for medicines by socioeconomic groups.Methods: Secondary data analysis of adult population aged 45 years and older from WHO Study on Global Ageing and Adult Health (SAGE) India 2015 (n=7397) and China Health and Retirement Longitudinal Study (CHARLS) 2015 (n=11 570). Log-linear, two-parts, zero-inflated and quantile regression models were performed to assess the association between multimorbidity and OOPE for medicines in both countries. Quantile regression was adopted to assess the observed relationship across OOPE distributions.Results: Based on 14 (11 self-reported) and 9 (8 self-reported) long-term conditions in the CHARLS and SAGE datasets, respectively, the prevalence of multimorbidity in the adult population aged 45 and older was found to be 63.4% in China and 42.2% in India. Of those with any long-term health condition, 38.6% in China and 20.9% in India had complex multimorbidity. Multimorbidity was significantly associated with higher OOPE for medicines in both countries (p<0.05); an additional physical long-term condition was associated with a 18.8% increase in OOPE for medicine in China (p<0.05) and a 20.9% increase in India (p<0.05). Liver disease was associated with highest increase in OOPE for medicines in China (61.6%) and stroke in India (131.6%). Diabetes had the second largest increase (China: 58.4%, India: 91.6%) in OOPE for medicines in both countries.Conclusion: Multimorbidity was associated with substantially higher OOPE for medicines in China and India compared with those without multimorbidity. Our findings provide supporting evidence of the need to improve financial protection for populations with an increased burden of chronic diseases in low-income and middle-income c

Journal article

Martinengo L, Jabir AI, Goh WWT, Lo NYW, Ho M-HR, Kowatsch T, Atun R, Michie S, Car LTet al., 2022, Conversational Agents in Health Care: Scoping Review of Their Behavior Change Techniques and Underpinning Theory, JOURNAL OF MEDICAL INTERNET RESEARCH, Vol: 24, ISSN: 1438-8871

Journal article

Dhinagaran DA, Martinengo L, Ho M-HR, Joty S, Kowatsch T, Atun R, Car LTet al., 2022, Designing, Developing, Evaluating, and Implementing a Smartphone-Delivered, Rule-Based Conversational Agent (DISCOVER): Development of a Conceptual Framework, JMIR MHEALTH AND UHEALTH, Vol: 10, ISSN: 2291-5222

Journal article

Xu Y, Geldsetzer P, Manne-Goehler J, Theilmann M, Marcus M-E, Zhumadilov Z, Quesnel-Crooks S, Mwalim O, Moghaddam SS, Koolaji S, Karki KB, Farzadfar F, Ebrahimi N, Damasceno A, Aryal KK, Agoudavi K, Atun R, Baernighausen T, Davies J, Jaacks LM, Vollmer S, Probst Cet al., 2022, The socioeconomic gradient of alcohol use: an analysis of nationally representative survey data from 55 low-income and middle-income countries, LANCET GLOBAL HEALTH, Vol: 10, Pages: E1268-E1280, ISSN: 2214-109X

Journal article

Flood D, Geldsetzer P, Agoudavi K, Aryal KK, Caldeira Brant LC, Brian G, Dorobantu M, Farzadfar F, Gheorghe-Fronea O, Gurung MS, Guwatudde D, Houehanou C, Adelin Jorgensen JM, Kondal D, Labadarios D, Marcus ME, Mayige M, Moghimi M, Norov B, Perman G, Quesnel-Crooks S, Rashidi M-M, Moghaddam SS, Seiglie JA, Bahendeka SK, Steinbrook E, Theilmann M, Ware LJ, Vollmer S, Atun R, Davies JI, Ali MK, Rohloff P, Manne-Goehler Jet al., 2022, Rural-Urban Differences in Diabetes Care and Control in 42 Low- and Middle-Income Countries: A Cross-sectional Study of Nationally Representative Individual-Level Data, DIABETES CARE, Vol: 45, Pages: 1961-1970, ISSN: 0149-5992

Journal article

Theilmann M, Lemp JM, Winkler V, Manne-Goehler J, Marcus ME, Probst C, Lopez-Arboleda WA, Ebert C, Bommer C, Mathur M, Andall-Brereton G, Bahendeka SK, Bovet P, Farzadfar F, Ghasemi E, Mayige MT, Moghaddam SS, Mwangi KJ, Naderimagham S, Sturua L, Atun R, Davies J, Baernighausen T, Vollmer S, Geldsetzer Pet al., 2022, Patterns of tobacco use in low and middle income countries by tobacco product and sociodemographic characteristics: nationally representative survey data from 82 countries, BMJ-BRITISH MEDICAL JOURNAL, Vol: 378, ISSN: 0959-535X

Journal article

Kirschbaum TK, Sudharsanan N, Manne-Goehler J, De Neve J-W, Lemp JM, Theilmann M, Marcus ME, Ebert C, Chen S, Yoosefi M, Sibai AM, Rouhifard M, Moghaddam SS, Mayige MT, Martins JS, Lunet N, Jorgensen JMA, Houehanou C, Farzadfar F, Damasceno A, Bovet P, Bahendeka SK, Aryal KK, Andall-Brereton G, Davies J, Atun R, Vollmer S, Barnighausen T, Jaacks LM, Geldsetzer Pet al., 2022, The Association of Socioeconomic Status With Hypertension in 76 Low- and Middle-Income Countries, JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, Vol: 80, Pages: 804-817, ISSN: 0735-1097

Journal article

Lee TY, Zhao Y, Anindya K, Atun R, Marthias T, Han C, McPake B, Duolikun N, Hulse E, Fang X, Ding Y, Oldenburg Bet al., 2022, Provincial heterogeneity in the management of care cascade for hypertension, diabetes, and dyslipidaemia in China: analysis of nationally representative population-based survey, Frontiers in Cardiovascular Medicine, Vol: 9, Pages: 1-16, ISSN: 2297-055X

Background This study aims to examine 1) province-level variations in the levels of cardiovascular disease (CVD) risk and behavioural risk for CVDs, 2) province-level variations in the management of cascade of care for hypertension, diabetes, and dyslipidaemia, and 3) the association of province-level economic development and individual factors with the quality of care for hypertension, diabetes, and dyslipidaemia.MethodsWe used nationally representative data from the China Health and Retirement Longitudinal Study in 2015, which included 12,597 participants aged 45 years. Using a care cascade framework, we examined the quality of care provided to patients with three prevalent NCDs: hypertension, diabetes, and dyslipidaemia. The proportion of WHO CVD risk based on the World Health Organisation CVD risk prediction charts, Cardiovascular Risk Score (CRS) and Behaviour Risk Score (BRS) were calculated. We performed multivariable logistic regression models to determine the individual-level drivers of NCD risk variables and outcomes. To examine socio-demographic relationships with CVD risk, linear regression models were applied.ResultsIn total, the average CRS was 4.98 (95 percent CI: 4.92, 5.05), while the average BRS was 3.10. (95 percent confidence interval: 3.04, 3.15). The weighted mean CRS (BRS) in Fujian province ranged from 4.36 to 5.72 (P<0.05). Most of the provinces had a greater rate of hypertension than diabetes and dyslipidaemia awareness and treatment. Northern provinces had a higher rate of awareness and treatment of all three diseases. Similar patterns of regional disparity were seen in diabetes and dyslipidaemia care cascades. There was no evidence of a better care cascade for CVDs in patients who reside in more economically advanced provinces.ConclusionOur research found significant provincial heterogeneity in the CVD risk scores and the management of the cascade of care for hypertension, diabetes, and dyslipidaemia for persons aged 45 years or more.

Journal article

Jain V, Atun R, Hansen P, Lorgelly Pet al., 2022, Which countries need COVID-19 vaccines the most? Development of a prioritisation tool, BMC PUBLIC HEALTH, Vol: 22

Journal article

Naylor NR, Evans S, Pouwels KB, Troughton R, Lamagni T, Muller-Pebody B, Knight GM, Atun R, Robotham JVet al., 2022, Quantifying the primary and secondary effects of antimicrobial resistance on surgery patients: Methods and data sources for empirical estimation in England, FRONTIERS IN PUBLIC HEALTH, Vol: 10

Journal article

Matz M, Gamkrelidze A, Mebonia N, Kereselidze M, Kazanjan K, Zhizhilashvili S, Atun R, Coleman MP, Allemani Cet al., 2022, Survival from five common cancers in Georgia, 2015-2019 (CONCORD), CANCER EPIDEMIOLOGY, Vol: 79, ISSN: 1877-7821

Journal article

Rizmie D, de Preux L, Miraldo M, Atun Ret al., 2022, Impact of extreme temperatures on emergency hospital admissions by age and socio-economic deprivation in England: Evidence from six diseases, Social Science &amp; Medicine, Vol: 308, Pages: 115193-115193, ISSN: 0277-9536

Climate change poses an unprecedented challenge to population health and health systems’ resilience, with increasing fluctuations in extreme temperatures through pressures on hospital capacity. While earlier studies have estimated morbidity attributable to hot or cold weather across cities, we provide the first large-scale, population-wide assessment of extreme temperatures on inequalities in excess emergency hospital admissions in England. We used the universe of emergency hospital admissions between 2001 and 2012 combined with meteorological data to exploit daily variation in temperature experienced by hospitals (N = 29,371,084). We used a distributed lag model with multiple fixed-effects, controlling for seasonal factors, to examine hospitalisation effects across temperature-sensitive diseases, and further heterogeneous impacts across age and deprivation. We identified larger hospitalisation impacts associated with extreme cold temperatures than with extreme hot temperatures. The less extreme temperatures produce admission patterns like their extreme counterparts, but at lower magnitudes. Results also showed an increase in admissions with extreme temperatures that were more prominent among older and socioeconomically-deprived populations - particularly across admissions for metabolic diseases and injuries.

Journal article

Martinengo L, Jabir AI, Goh WWT, Lo NYW, Ho M-HR, Kowatsch T, Atun R, Michie S, Tudor Car Let al., 2022, Conversational agents in healthcare: a scoping review of their behavior change techniques and underpinning theory (Preprint)

<sec> <title>BACKGROUND</title> <p>Conversational agents (CAs) are increasingly used in healthcare to deliver behavior change interventions. Their evaluation often includes categorizing the behavior change techniques (BCTs), using a classification system of which the BCT Taxonomy V1 is one of the most common. Previous studies have presented descriptive summaries of behavior change interventions delivered by CAs, but no in-depth study reporting the use of BCTs in these interventions has been published to date.</p> </sec> <sec> <title>OBJECTIVE</title> <p>We aimed to describe behavior change interventions delivered by CAs and identify the behavior change techniques (BCTs) and theories guiding their design.</p> </sec> <sec> <title>METHODS</title> <p>We searched PubMed, Embase, Cochrane’s CENTRAL, and the first ten pages of Google and Google Scholar in April 2021. We included primary, experimental studies evaluating a behavior change intervention delivered by a CA. BCTs coding followed the BCT Taxonomy v1. Two independent reviewers selected the studies and extracted the data. Descriptive analysis and frequent itemset mining to identify BCT clusters were performed. </p> </sec> <sec> <title>RESULTS</title> <p>We included 47 studies reporting on mental health (n=19, 40%), chronic disorders (n=14, 30%), and lifestyle change (n=14, 30%) interventions. There were 20 embodied CAs (43%) and 27 CAs (57%) represented a female character. Most CAs were rule-based (n=34, 72%). Experimental interventions included 63 BCTs, (mean: 9 BCTs, range 2-21)

Journal article

Atun R, 2022, Strategic Public-Private Partnerships to Transform Cardiovascular Health, HPHR Journal, Vol: HSIL, ISSN: 2643-6450

<jats:p>The study, Strategic Public-Private Partnerships to Transform Cardiovascular Health, was developed under the guidance of Professor Rifat Atun, Professor of Global Health Systems at Harvard University and Director of the Health Systems Innovation Lab and implemented by a team consisting of Dr Ché L. Reddy, Associate Director Health Systems Innovation Lab, Harvard University, Dr Lindsay M. Murphy and Dr Carlo Ross, Research Assistants at Health Systems Innovation Lab, Harvard University. The ideas, insights and frameworks in the report are drawn from earlier research at the Health System Innovation Lab combined with a systematic literature review and interviews with leaders involved in the development and implementation of strategic Public-Private Partnerships to transform Cardiovascular Health.</jats:p>

Journal article

Rifat A, 2022, The State of Cardiovascular Disease in G20+ Countries​, HPHR Journal, Vol: HSIL, ISSN: 2643-6450

<jats:p>The study, The State of Cardiovascular Disease in G20+ Countries, was developed under the guidance of Professor Rifat Atun, Professor of Global Health Systems at the Harvard T.H. Chan School of Public Health at Harvard University and Director of the Health Systems Innovation Lab and Francesca Colombo, Head of the Health Division at the Organization for Economic Cooperation and Development (OECD) and implemented by a team of researchers and contributors from the Health Systems Innovation Lab (HSIL) at Harvard University and the OECD, including: Dr Thanitsara Rittiphairoj, Research Assistant, HSIL, Dr Amanda Reilly, Research Assistant, HSIL, Dr Ché L. Reddy, Associate Director, HSIL, Dr Eliana Barrenho, OECD, Dr Nicolaas Klazinga, OECD, Katherine de Bienassis, OECD, Lucy Hallett, OECD.</jats:p>

Journal article

Dhinagaran DA, Martinengo L, Ho M-HR, Joty S, Kowatsch T, Atun R, Tudor Car Let al., 2022, Designing, developing, evaluating, and Implementing a Smartphone-delivered, rule-based COnVERsational agent (DISCOVER): a conceptual framework (Preprint)

<sec> <title>BACKGROUND</title> <p>Conversational agents (CAs), also known as chatbots are computer programs that simulate human conversations using predetermined rule-based responses or employing artificial intelligent algorithms. They are increasingly used in healthcare, particularly via smartphones. There is, at present no conceptual framework guiding the development of smartphone rule-based CAs in healthcare. To fill this gap we propose structured and tailored guidance for their design, development, evaluation, and implementation.</p> </sec> <sec> <title>OBJECTIVE</title> <p>To develop a conceptual framework for the design, evaluation, and implementation of smartphone-delivered, rule-based, goal-oriented, and text-based CAs for healthcare.</p> </sec> <sec> <title>METHODS</title> <p>We followed Jabareen’s approach to develop this conceptual framework. We performed two literature reviews focusing on healthcare CAs and conceptual frameworks for the development of mHealth interventions. We identified, named, categorized, integrated, and synthesized the information retrieved from the literature reviews to develop the conceptual framework. We then applied this framework by developing a CA and testing it in a feasibility study.</p> </sec> <sec> <title>RESULTS</title> <p>The DISCOVER conceptual framework includes eight iterative steps, grouped into three stages: (1) Design, comprising defining the goal, creating an identity, assembling the team, and selecting the delivery interface, (2) Development, including developing the content an

Journal article

Rittiphairoj T, Owais M, Ward ZJ, Reddy CL, Yeh JM, Atun Ret al., 2022, Incidence and prevalence of type 1 diabetes and diabetic ketoacidosis in children and adolescents (0-19 years) in Thailand (2015-2020): A nationwide population-based study, LANCET REGIONAL HEALTH-WESTERN PACIFIC, Vol: 21

Journal article

George G, Chaturvedi S, Corbishley C, Atun Ret al., 2022, Relational coordination and stigma at work: how frontline employees compensate for failures in public health systems, Journal of Management Studies, ISSN: 0022-2380

Co-ordinating collective work and communicating a shared understanding of tasks is necessary to accomplishing organizational goals. Stigma could exacerbate co-ordination challenges between public and private organizations by further widening differences in goals and incentives among employees. Using relational co-ordination theory, we explore how stigma can influence employee behaviour in the context of healthcare delivery. We study healthcare professionals and frontline workers involved in the fight against AIDS in India to examine how public health systems fail due to a lack of communication and co-ordination, and that these failures are worsened by stigma. When stigma is present, relationships between employees become strained due to misaligned work routines, lack of information sharing and cooperation failure. Our findings reveal emergent responses from frontline employees that mitigate co-ordination failures through: (1) role adaptation to improve predictability of tasks; (2) social purpose identification to promote a common understanding and engage stigmatized clients; and (3) affective attachment that encourages extra-role behaviours and task ownership. We draw implications for relational co-ordination and stigma, as well as public-private co-ordination in public health systems.

Journal article

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

Journal article

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