Digital health informatics – establishing an evidence-based foundation

Pathology ◽  
2018 ◽  
Vol 50 ◽  
pp. S3
Author(s):  
Andrew Georgiou
Keyword(s):  
Health Informatics ◽  
Digital Health ◽  
Evidence Based

scholarly journals Evidence-Based Health Informatics as the Foundation for the COVID-19 Response: A Joint Call for Action

2021 ◽  
Author(s):  
Luis Fernandez-Luque ◽  
Andre W. Kushniruk ◽  
Andrew Georgiou ◽  
Arindam Basu ◽  
Carolyn Petersen ◽  
...  
Keyword(s):  
Public Health ◽  
Interest Groups ◽  
Special Interest ◽  
Health Informatics ◽  
Digital Health ◽  
Health Interventions ◽  
Digital Tools ◽  
Special Interest Groups ◽  
Evidence Based ◽  
Health Crisis

Abstract Background As a major public health crisis, the novel coronavirus disease 2019 (COVID-19) pandemic demonstrates the urgent need for safe, effective, and evidence-based implementations of digital health. The urgency stems from the frequent tendency to focus attention on seemingly high promising digital health interventions despite being poorly validated in times of crisis. Aim In this paper, we describe a joint call for action to use and leverage evidence-based health informatics as the foundation for the COVID-19 response and public health interventions. Tangible examples are provided for how the working groups and special interest groups of the International Medical Informatics Association (IMIA) are helping to build an evidence-based response to this crisis. Methods Leaders of working and special interest groups of the IMIA, a total of 26 groups, were contacted via e-mail to provide a summary of the scientific-based efforts taken to combat COVID-19 pandemic and participate in the discussion toward the creation of this manuscript. A total of 13 groups participated in this manuscript. Results Various efforts were exerted by members of IMIA including (1) developing evidence-based guidelines for the design and deployment of digital health solutions during COVID-19; (2) surveying clinical informaticians internationally about key digital solutions deployed to combat COVID-19 and the challenges faced when implementing and using them; and (3) offering necessary resources for clinicians about the use of digital tools in clinical practice, education, and research during COVID-19. Discussion Rigor and evidence need to be taken into consideration when designing, implementing, and using digital tools to combat COVID-19 to avoid delays and unforeseen negative consequences. It is paramount to employ a multidisciplinary approach for the development and implementation of digital health tools that have been rapidly deployed in response to the pandemic bearing in mind human factors, ethics, data privacy, and the diversity of context at the local, national, and international levels. The training and capacity building of front-line workers is crucial and must be linked to a clear strategy for evaluation of ongoing experiences.

scholarly journals Evidence-Based Digital Tools for Weight Loss Maintenance: The NoHoW Project

Obesity Facts ◽  
2021 ◽  
pp. 1-14
Author(s):  
R. James Stubbs ◽  
Cristiana Duarte ◽  
António L. Palmeira ◽  
Falko F. Sniehotta ◽  
Graham Horgan ◽  
...  
Keyword(s):  
Weight Loss ◽  
Behaviour Change ◽  
Digital Health ◽  
Self Regulation ◽  
Self Management ◽  
Behaviour Change Techniques ◽  
Evidence Based ◽  
Behavioural Science ◽  
Digital Architecture

<b><i>Background:</i></b> Effective interventions and commercial programmes for weight loss (WL) are widely available, but most people regain weight. Few effective WL maintenance (WLM) solutions exist. The most promising evidence-based behaviour change techniques for WLM are self-monitoring, goal setting, action planning and control, building self-efficacy, and techniques that promote autonomous motivation (e.g., provide choice). Stress management and emotion regulation techniques show potential for prevention of relapse and weight regain. Digital technologies (including networked-wireless tracking technologies, online tools and smartphone apps, multimedia resources, and internet-based support) offer attractive tools for teaching and supporting long-term behaviour change techniques. However, many digital offerings for weight management tend not to include evidence-based content and the evidence base is still limited. <b><i>The Project:</i></b> First, the project examined why, when, and how many European citizens make WL and WLM attempts and how successful they are. Second, the project employed the most up-to-date behavioural science research to develop a digital toolkit for WLM based on 2 key conditions, i.e., self-management (self-regulation and motivation) of behaviour and self-management of emotional responses for WLM. Then, the NoHoW trial tested the efficacy of this digital toolkit in adults who achieved clinically significant (≥5%) WL in the previous 12 months (initial BMI ≥25). The primary outcome was change in weight (kg) at 12 months from baseline. Secondary outcomes included biological, psychological, and behavioural moderators and mediators of long-term energy balance (EB) behaviours, and user experience, acceptability, and cost-effectiveness. <b><i>Impact:</i></b> The project will directly feed results from studies on European consumer behaviour, design and evaluation of digital toolkits self-management of EB behaviours into development of new products and services for WLM and digital health. The project has developed a framework and digital architecture for interventions in the context of EB tracking and will generate results that will help inform the next generation of personalised interventions for effective self-management of weight and health.

scholarly journals Steps in Moving Evidence-Based Health Informatics from Theory to Practice

2016 ◽  
Vol 22 (4) ◽  
pp. 255 ◽  
Author(s):  
Michael Rigby ◽  
Farah Magrabi ◽  
Philip Scott ◽  
Persephone Doupi ◽  
Hannele Hypponen ◽  
...  
Keyword(s):  
Health Informatics ◽  
Evidence Based ◽  
Theory To Practice

scholarly journals Translating evidence-based treatment for digital health delivery: a protocol for family-based treatment for anorexia nervosa using telemedicine

2020 ◽  
Vol 8 (1) ◽  
Author(s):  
A. Hambleton ◽  
D. Le Grange ◽  
J. Miskovic-Wheatley ◽  
S. Touyz ◽  
M. Cunich ◽  
...  
Keyword(s):  
Anorexia Nervosa ◽  
Young People ◽  
Treatment Effectiveness ◽  
Digital Health ◽  
Evidence Based ◽  
Treatment Needs ◽  
Evidence Based Treatment ◽  
Face To Face ◽  
Family Based Treatment ◽  
Family Based

Abstract Background Family-based treatment (FBT) is an efficacious outpatient intervention for young people diagnosed with Anorexia Nervosa (AN). To date, treatment to protocol has relied on standard face-to-face delivery. Face-to-face therapy is subject to geographic, temporal and human factors, rendering it particularly susceptible to inequities and disruption. This has resulted in poorer service provision for rural and regional families, and recently a significant challenge to providing face-to-face services during the COVID-19 global pandemic. The present study examines whether FBT for AN can be successfully translated to a digital delivery platform to address these access issues. Method Forty young people aged 12 to 18 years who meet DSM-5 diagnostic criteria for AN, and live in a rural or regional setting, will along with their family be recruited to the study. Trained therapists will provide 18 sessions of FBT over 9 months via telemedicine to the home of the young person and their family. The analysis will examine treatment effectiveness, feasibility, acceptability, and cost-effectiveness. Discussion The study addresses the treatment needs of families not able to attend face-to-face clinical services for evidence-based treatment for eating disorders. This might be due to several barriers, including a lack of local services or long travel distances to services. There has been a recent and unprecedented demand for telemedicine to facilitate the continuity of care during COVID-19 despite geographical circumstances. If delivering treatment in this modality is clinically and economically effective and feasible, it will facilitate access to potentially lifesaving, evidence-based treatments for families formerly unable to access such care and provide evidence for the continuity of services when and where face-to-face treatment is not feasible.

scholarly journals Effectiveness, Acceptability, and Feasibility of Digital Health Interventions for LGBTIQ+ Young People: Systematic Review

10.2196/20158 ◽  
2020 ◽  
Vol 22 (12) ◽  
pp. e20158
Author(s):  
Dylan Gilbey ◽  
Helen Morgan ◽  
Ashleigh Lin ◽  
Yael Perry
Keyword(s):  
Young People ◽  
Sexual Health ◽  
Digital Health ◽  
Health Interventions ◽  
Health Concern ◽  
Sufficient Evidence ◽  
Future Research ◽  
Evidence Based ◽  
Bisexual Men ◽  
Targeted Interventions

Background Young people (aged 12-25 years) with diverse sexuality, gender, or bodily characteristics, such as those who identify as lesbian, gay, bisexual, transgender, intersex, or queer (LGBTIQ+), are at substantially greater risk of a range of mental, physical, and sexual health difficulties compared with their peers. Digital health interventions have been identified as a potential way to reduce these health disparities. Objective This review aims to summarize the characteristics of existing evidence-based digital health interventions for LGBTIQ+ young people and to describe the evidence for their effectiveness, acceptability, and feasibility. Methods A systematic literature search was conducted using internet databases and gray literature sources, and the results were screened for inclusion. The included studies were synthesized qualitatively. Results The search identified 38 studies of 24 unique interventions seeking to address mental, physical, or sexual health–related concerns in LGBTIQ+ young people. Substantially more evidence-based interventions existed for gay and bisexual men than for any other population group, and there were more interventions related to risk reduction of sexually transmitted infections than to any other health concern. There was some evidence for the effectiveness, feasibility, and acceptability of these interventions overall; however, the quality of evidence is often lacking. Conclusions There is sufficient evidence to suggest that targeted digital health interventions are an important focus for future research aimed at addressing health difficulties in LGBTIQ+ young people. Additional digital health interventions are needed for a wider range of health difficulties, particularly in terms of mental and physical health concerns, as well as more targeted interventions for same gender–attracted women, trans and gender-diverse people, and people with intersex variations. Trial Registration PROSPERO International Prospective Register of Systematic Reviews CRD42020128164; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=128164

scholarly journals The challenge of bringing evidence in decision-making for public health emergencies: can preparedness reach out to HTA?

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
C E Chronaki ◽  
A Miglietta
Keyword(s):  
Public Health ◽  
Decision Making ◽  
Policy Development ◽  
Digital Health ◽  
Resource Planning ◽  
Public Health Emergency ◽  
Evidence Based ◽  
Public Health Emergencies ◽  
The Impact ◽  
Evidence Based Decision Making

Abstract Evidence-based decision-making is central to public health. Implementing evidence-informed actions is most challenging during a public health emergency as in an epidemic, when time is limited, scientific uncertainties and political pressures tend to be high, and reliable data is typically lacking. The process of including data for preparedness and training for evidence-based decision making in public health emergencies is not systematic and is complicated by many barriers as the absence of common digital tools and approaches for resource planning and update of response plans. Health Technology Assessment (HTA) is used with the aim to improve the quality and efficiency of public health interventions and to make healthcare systems more sustainable. Many of today's public health crises are also cross-border, and countries need to collaborate in a systematic and standardized way in order to enhance interoperability to share data and to plan coordinated response. Digital health tools have an important role to play in this setting, facilitating use of knowledge about the population that can potentially affected by the crisis within and across regional and national borders. To strengthen the impact of scientific evidence on decision-making for public health emergency preparedness and response, it is necessary to better define and align mechanisms through which interdisciplinary evidence feeds into decision-making processes during public health emergencies and the context in which these mechanisms operate. Activities and policy development in the HTA network could inform this process. The objective of this presentation is to identify barriers for evidence-based decision making during public health emergencies and discuss how standardization in digital health and HTA processes may help overcome these barriers leading to more effective coordinated and evidence-based public health emergency response.

scholarly journals Evaluation of the Implementation Process of the Mobile Health Platform ‘WelTel’ in Six Sites in East Africa and Canada Using the Modified Consolidated Framework for Implementation Research (mCFIR)

2020 ◽  
Author(s):  
Samia El Joueidi ◽  
Kevin Bardosh ◽  
Richard Musoke ◽  
Binyam Tilahun ◽  
Maryam Abo Moslim ◽  
...  
Keyword(s):  
Implementation Research ◽  
Digital Health ◽  
Descriptive Analysis ◽  
Scale Up ◽  
Implementation Process ◽  
Evidence Based ◽  
Structured Interviews ◽  
User Friendliness ◽  
Domain 3 ◽  
And Performance

Abstract Background: Health systems globally are investing in integrating secure messaging platforms for virtual care in clinical practice. Implementation science is essential for adoption, scale-up, spread and maintenance of complex evidence-based solutions in clinics with evolving priorities. In response, the mHealth Research Group modified the existing Consolidated Framework for Implementation Research (mCFIR) to evaluate implementation of virtual health tools in clinical settings. WelTel® is an evidence-based digital health platform widely deployed in various geographical and health contexts. Objectives: To identify the facilitators and barriers for implementing WelTel and to assess the application of the mCFIR tool in facilitating focus groups in different geographical and health settings. Methodology: Both qualitative and semi-quantitative approaches were employed. Six mCFIR sessions were held in three countries with 51 key stakeholders surveyed. The mCFIR tool consists of 5 Domains and 25 Constructs and was built and distributed through Qualtrics XM. “Performance ” and “Importance” scores were valued on a scale of 0 to 10 (Mean + SD). Descriptive analysis was conducted using R computing software. NVivo 12 Pro software was used to analyze mCFIR responses and to generate themes from the participants’ input. Semi-structured interviews were conducted with the focus group facilitators to understand their experience using the mCFIR tool. Results: We observed a parallel trend in the scores for Importance and Performance. Of the five Domains, Domain 4 (End-user Characteristics) and Domain 3 (Inner Settings) scored highest in Importance (8.9 + 0.5 and 8.6 + 0.6, respectively) and Performance (7.6 + 0.7 and 7.2 + 1.3, respectively) for all sites. Domain 2 (Outer Setting) scored the lowest in both Importance and Performance for all sites (7.6 + 0.4 and 5.6 + 1.8). Areas of strengths included timely diagnosis, immediate response, cost-effectiveness, user-friendliness, and simplicity. Areas for improvement included training, phone accessibility, health authority’s engagement, and literacy. Conclusion: The mCFIR tool allowed for a comprehensive understanding of the barriers and facilitators to the implementation, reach, and scale-up of digital health tools. Participants emphasized the importance of creating partnerships with external organizations and health authorities in order to achieve sustainability and scalability.Trial Registration: NCT02603536 – November 11, 2015NCT01549457 – March 9, 2012

scholarly journals Evaluation Considerations for Secondary Uses of Clinical Data: Principles for an Evidence-based Approach to Policy and Implementation of Secondary Analysis

2017 ◽  
Vol 26 (01) ◽  
pp. 59-67 ◽  
Author(s):  
P. J. Scott ◽  
M. Rigby ◽  
E. Ammenwerth ◽  
J. McNair ◽  
A. Georgiou ◽  
...  
Keyword(s):  
Clinical Data ◽  
Health Informatics ◽  
Best Practice ◽  
Data Science ◽  
Clinical Performance ◽  
Secondary Analysis ◽  
Health Data ◽  
Evidence Based ◽  
Great Expectations ◽  
Scientific Context

Summary Objectives: To set the scientific context and then suggest principles for an evidence-based approach to secondary uses of clinical data, covering both evaluation of the secondary uses of data and evaluation of health systems and services based upon secondary uses of data. Method: Working Group review of selected literature and policy approaches. Results: We present important considerations in the evaluation of secondary uses of clinical data from the angles of governance and trust, theory, semantics, and policy. We make the case for a multi-level and multi-factorial approach to the evaluation of secondary uses of clinical data and describe a methodological framework for best practice. We emphasise the importance of evaluating the governance of secondary uses of health data in maintaining trust, which is essential for such uses. We also offer examples of the re-use of routine health data to demonstrate how it can support evaluation of clinical performance and optimize health IT system design. Conclusions: Great expectations are resting upon “Big Data” and innovative analytics. However, to build and maintain public trust, improve data reliability, and assure the validity of analytic inferences, there must be independent and transparent evaluation. A mature and evidence-based approach needs not merely data science, but must be guided by the broader concerns of applied health informatics.

scholarly journals Quality and Safety in eHealth: The Need to Build the Evidence Base (Preprint)

2019 ◽  
Author(s):  
Elizabeth Borycki
Keyword(s):  
Health Informatics ◽  
Improve Patient Safety ◽  
Health Technology ◽  
Evidence Base ◽  
Evidence Based ◽  
Quality And Safety ◽  
Design Development ◽  
Health Technologies ◽  
Safety Science ◽  
Improve Patient

UNSTRUCTURED Research in the area of health technology safety has demonstrated that technology may both improve patient safety and introduce new types of technology-induced errors. Thus, there is a need to publish safety science literature to develop an evidence-based research base, on which we can continually develop new, safe technologies and improve patient safety. The aim of this viewpoint is to argue for the need to advance evidence-based research in health informatics, so that new technologies can be designed, developed, and implemented for their safety prior to their use in health care. This viewpoint offers a historical perspective on the development of health informatics and safety literature in the area of health technology. I argue for the need to conduct safety studies of technologies used by health professionals and consumers to develop an evidence base in this area. Ongoing research is necessary to improve the quality and safety of health technologies. Over the past several decades, we have seen health informatics emerge as a discipline, with growing research in the field examining the design, development, and implementation of different health technologies and new challenges such as those associated with the quality and safety of technology use. Future research will need to focus on how we can continually extend safety science in this area. There is a need to integrate evidence-based research into the design, development, and implementation of health technologies to improve their safety and reduce technology-induced errors.

scholarly journals Sensor, Signal, and Imaging Informatics: Evidence-Based Health Informatics

2013 ◽  
Vol 22 (01) ◽  
pp. 117-119
Author(s):  
A. Moreau-Gaudry ◽  
S. Voros
Keyword(s):  
Health Informatics ◽  
Peer Review Process ◽  
Wide Spectrum ◽  
Imaging Informatics ◽  
Added Value ◽  
Evidence Based ◽  
Sensor Signal ◽  
Optimal Care ◽  
Double Blind ◽  
Excellent Research

Summary Objectives: This synopsis presents a selection for the IMIA (International Medical Informatics Association) Yearbook 2013 of excellent research in the broad field of Sensor, Signal, and Imaging Informatics published in the year 2012. Methods: We performed a systematic initial selection and a double blind peer review process to find the best papers in this domain published in 2012, from the PubMed and Web of Science databases. A set of MeSH keywords provided by experts was used. Results: Current research in the field of sensor signal and imaging informatics is based on innovative sensors from which relevant information (signal and imaging) can be acquired and integrated into workflow based or patient based models. This rich environment can help the medical staff in carrying out more optimal care. The demonstration of the added value of such innovations is more and more performed through evidence-based evaluations. Conclusions: The best paper selection of articles on sensors, signal, and imaging informatics illustrates the wide spectrum covered by this field in 2012, and the attention paid to evaluations.

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