Computer-assisted versus oral-and-written history taking for the management of cardiovascular disease

2015 ◽  
Author(s):  
Lucinda Cash-Gibson ◽  
Yannis Pappas ◽  
Josip Car
Keyword(s):  
Cardiovascular Disease ◽  
Computer Assisted ◽  
History Taking

scholarly journals Computer-Assisted versus Oral-and-Written History Taking for the Prevention and Management of Cardiovascular Disease: a Systematic Review of the Literature

2017 ◽  
Vol 60 (3) ◽  
pp. 97-107 ◽  
Author(s):  
Yannis Pappas ◽  
Jitka Všetečková ◽  
Shoba Poduval ◽  
Pei Ching Tseng ◽  
Josip Car
Keyword(s):  
Systematic Review ◽  
Cardiovascular Disease ◽  
Cochrane Collaboration ◽  
Evidence Base ◽  
Sufficient Evidence ◽  
Control Group ◽  
Computer Assisted ◽  
History Taking ◽  
Inclusion Criteria ◽  
Cvd Prevention

Background and objectives: CVD is an important global healthcare issue; it is the leading cause of global mortality, with an increasing incidence identified in both developed and developing countries. It is also an extremely costly disease for healthcare systems unless managed effectively. In this review we aimed to: – Assess the effect of computer-assisted versus oral-and-written history taking on the quality of collected information for the prevention and management of CVD. – Assess the effect of computer-assisted versus oral-and-written history taking on the prevention and management of CVD. Methods: A systematic review of randomised controlled trials that included participants of 16 years or older at the beginning of the study, who were at risk of CVD (prevention) or were either previously diagnosed with CVD (management). We searched all major databases. We assessed risk of bias using the Cochrane Collaboration tool. Results: Two studies met the inclusion criteria. One comparing the two methods of history-taking for the prevention of cardiovascular disease n = 75. The study shows that generally the patients in the experimental group underwent more laboratory procedures, had more biomarker readings recorded and/or were given (or had reviewed), more dietary changes than the control group. The other study compares the two methods of history-taking for the management of cardiovascular disease (n = 479). The study showed that the computerized decision aid appears to increase the proportion of patients who responded to invitations to discuss CVD prevention with their doctor. The Computer- Assisted History Taking Systems (CAHTS) increased the proportion of patients who discussed CHD risk reduction with their doctor from 24% to 40% and increased the proportion who had a specific plan to reduce their risk from 24% to 37%. Discussion: With only one study meeting the inclusion criteria, for prevention of CVD and one study for management of CVD we did not gather sufficient evidence to address all of the objectives of the review. We were unable to report on most of the secondary patient outcomes in our protocol. Conclusions: We tentatively conclude that CAHTS can provide individually-tailored information about CVD prevention. However, further primary studies are needed to confirm these findings. We cannot draw any conclusions in relation to any other clinical outcomes at this stage. There is a need to develop an evidence base to support the effective development and use of CAHTS in this area of practice. In the absence of evidence on effectiveness, the implementation of computer-assisted history taking may only rely on the clinicians’ tacit knowledge, published monographs and viewpoint articles.

Abstract 16725: Family History of Cardiovascular Disease is an Independent Predictor of Gestational Hypertensive Disease and Diabetes: The Korean Nurses’ Survey

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Heesun Lee ◽  
Chang-Hwan Yoon ◽  
Hyun-Young Park ◽  
Hea Young Lee ◽  
Dong-Ju Choi ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Family History ◽  
Gestational Diabetes ◽  
Medical Knowledge ◽  
Multivariate Logistic Regression Analysis ◽  
Computer Assisted ◽  
Hypertensive Disease ◽  
Medical Disorders ◽  
Hypertensive Disorders ◽  
History Of

Background: Gestational hypertensive disorders and diabetes are well-known to increase the risk of cardiovascular disease (CVD) and diabetes later in life. However, there were few researches to evaluate the association between family history of cardiovascular disease and the occurrence of pregnancy-related medical disorders. We aimed to investigate whether family history of CVD could predict gestational hypertensive disorders and diabetes. Methods: The Korean Nurses’ Survey was conducted through web-based computer-assisted self-administered questionnaires, which were compiled by consultation to cardiologists, gynecologists, and statisticians, from October to December 2011. We enrolled a total of 9,989 female registered nurses who could answer reliably the questionnaires based on their medical knowledge. Multivariate logistic regression analysis was used to clarify the effect of family history of CVD on pregnancy-related medical disorders. Result: In this survey, 3900 subjects had more than 1 pregnancy. Among them, 247 interviewees (6.3%) had experienced hypertensive disorders during pregnancy, which included preeclampsia (n = 160, 4.1%) and transient hypertension (n = 144, 3.7%), and 120 (3.1%) had experienced gestational diabetes. And, 2872 subjects (73.6%) answered that they had at least 1 family history of CVD. Having family history of CVD increased the risk of gestational hypertensive disorders (adjusted RR 1.51, 95% CI 1.08-2.11, p = 0.015) and diabetes (adjusted RR 2.40, 95% CI 1.38-4.17, p = 0.002). In particular, family history of hypertension was significantly associated with gestational hypertensive disorders (adjusted RR 2.00, 95% CI 1.47-2.50, p <0.001), and diabetes was highly related with gestational diabetes (adjusted RR 3.37, 95% CI 2.35-4.83, p <0.001), respectively. Furthermore, this relationship was observed regardless of maternal parity. Conclusion: Family history of CVD was a significant predictor of pregnancy-related medical disorders in this survey. Meticulous history taking for family history of CVD can provide the risk of gestational hypertensive disease and diabetes. Thus, special attention should be paid to women with family history of CVD during pregnancy.

scholarly journals Computer-assisted history-taking systems (CAHTS) in health care: benefits, risks and potential for further development

2011 ◽  
Vol 19 (3) ◽  
pp. 155-160 ◽  
Author(s):  
Yannis Pappas ◽  
Chantelle Anandan ◽  
Joseph Liu ◽  
Josip Car ◽  
Aziz Sheikh ◽  
...  
Keyword(s):  
Health Care ◽  
Computer Assisted ◽  
History Taking ◽  
Health Care Benefits ◽  
Further Development

scholarly journals The computer will see you now: Overcoming barriers to adoption of computer assisted history taking (CAHT) in primary care (Preprint)

2020 ◽  
Author(s):  
Pier Spinazze ◽  
Marise Kasteleyn ◽  
Jiska Aardoom ◽  
Niels Chavannes
Keyword(s):  
Healthcare Delivery ◽  
Computer Assisted ◽  
History Taking ◽  
Barriers To Adoption ◽  
Multiple Modalities ◽  
Face To Face ◽  
Patient Health ◽  
Negative Health Outcomes ◽  
Personal Devices ◽  
Consultation Time

UNSTRUCTURED Patient health information is increasingly collected through multiple modalities, including EHRs, wearables and connected devices. Computer-assisted history taking (CAHT) could provide an additional channel to collect highly relevant, comprehensive, and accurate patient information whilst reducing the burden on clinicians and face-to-face consultation time. Considering restrictions to consultation time and the associated negative health outcomes, patient-provided health data outside of consultation can prove invaluable in healthcare delivery. Over the years, research has highlighted the numerous benefits of CAHT, however, the limitations have proved an obstacle to adoption. In this viewpoint we review these limitations under four main categories: accessibility, affordability, accuracy, and acceptability and discuss how advances in technology, computing power and ubiquity of personal devices offer solutions to overcoming these.

Abstract P253: Blood Pressure Status Among Current Cigarette, E-cigarette, And Marijuana Users In The United States: An Analysis Of The National Health And Nutrition Examination Surveys, 2013-2016

Circulation ◽  
2020 ◽  
Vol 141 (Suppl_1) ◽  
Author(s):  
Denise C Vidot ◽  
Lenette M Jones ◽  
Yendelela Cuffee ◽  
Amber Johnson ◽  
Lizelh Ayala
Keyword(s):  
Blood Pressure ◽  
Cardiovascular Disease ◽  
National Health ◽  
Disease Risk ◽  
Cardiovascular Disease Risk ◽  
Survey Method ◽  
Computer Assisted ◽  
Health And Nutrition ◽  
Prevalence Estimates ◽  
Stage 1

Introduction: Tobacco and marijuana have been associated with abnormal blood pressure (BP). Yet, little is known about differences in BP status among individuals who smoke cigarettes, e-cigarettes, and marijuana, independently or in combination. The purpose of this study was to provide prevalence estimates of elevated BP, stage 1 hypertension, and stage 2 hypertension among smokers of varied substances and route of administration. Hypothesis: We hypothesized that cigarette users would have higher BP levels compared to e-cigarette or marijuana users. Methods: Data from adults (20-to-59 years) who completed the National Health and Nutrition Examination Surveys between 2013 and 2016 (N=6,282) were examined. Smoking status was ascertained by self-report of use in the last 30-days via computer assisted questionnaires as: cigarette only, cigarette + marijuana, cigarette + e-cigarette, e-cigarette only, e-cigarette + marijuana, marijuana only, and non-smokers of any product. BP was ascertained by the average of three systolic and diastolic readings. Following the latest BP guidelines, BP was categorized as elevated, hypertension stage 1 (HTN1), or hypertension stage 2 (HTN2). Survey method-appropriate chi-squared analyses were conducted to provide weighted prevalence estimates. Results: Over half (60.6%) of the adults in the sample were current smokers [cigarette only (31.9%); e-cigarette only (1.4%); marijuana only (7.3%); cigarette + marijuana (16.1%), cigarette + e-cigarette (3.1%), e-cigarette + marijuana (0.7%)]. A quarter (25.5%) of the sample had elevated BP; 43.9% had HTN1; and 12.7% had HTN2. Among smokers, cigarette only users had the highest prevalence of elevated BP (7.7%), HTN1 (14.7%), and HTN2 (4.3%); followed by the combined use of cigarettes and marijuana (4.8%, 6.0%, 1.2%, respectively). Marijuana and e-cigarette combination users had the lowest prevalence of HTN1 (0.16%) and HTN2 (0.0%) followed by marijuana only users (2.8%, 0.9%, respectively; p=0.04). Conclusions: This analysis is among the first to leverage population-based data to assess BP status among independent and combination users of cigarettes, e-cigarettes, and marijuana. The majority of the sample had at least elevated BP, which is documented to increase cardiovascular disease risk. Additional studies are needed to evaluate the impact of frequency and duration of use on cardiovascular disease risk after considering other lifestyle behaviors (i.e., diet and physical activity).

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