scholarly journals The impact of mobile technology on teamwork and communication in hospitals: a systematic review

2019 ◽  
Vol 26 (4) ◽  
pp. 339-355 ◽  
Author(s):  
Guy Martin ◽  
Ankur Khajuria ◽  
Sonal Arora ◽  
Dominic King ◽  
Hutan Ashrafian ◽  
...  
Keyword(s):  
Systematic Review ◽  
Mobile Technology ◽  
Hospital Setting ◽  
Mobile Technologies ◽  
Cochrane Library ◽  
High Quality ◽  
Safe Delivery ◽  
High Quality Evidence ◽  
The Impact ◽  
Quality Evidence

Abstract Objectives Effective communication is critical to the safe delivery of care but is characterized by outdated technologies. Mobile technology has the potential to transform communication and teamwork but the evidence is currently uncertain. The objective of this systematic review was to summarize the quality and breadth of evidence for the impact of mobile technologies on communication and teamwork in hospitals. Materials and Methods Electronic databases (MEDLINE, PsycINFO, EMBASE, CINAHL Plus, HMIC, Cochrane Library, and National Institute of Health Research Health Technology Assessment) were searched for English language publications reporting communication- or teamwork-related outcomes from mobile technologies in the hospital setting between 2007 and 2017. Results We identified 38 publications originating from 30 studies. Only 11% were of high quality and none met best practice guidelines for mobile-technology-based trials. The studies reported a heterogenous range of quantitative, qualitative, and mixed-methods outcomes. There is a lack of high-quality evidence, but nonetheless mobile technology can lead to improvements in workflow, strengthen the quality and efficiency of communication, and enhance accessibility and interteam relationships. Discussion This review describes the potential benefits that mobile technology can deliver and that mobile technology is ubiquitous among healthcare professionals. Crucially, it highlights the paucity of high-quality evidence for its effectiveness and identifies common barriers to widespread uptake. Limitations include the limited number of participants and a wide variability in methods and reported outcomes. Conclusion Evidence suggests that mobile technology has the potential to significantly improve communication and teamwork in hospital provided key organizational, technological, and security challenges are tackled and better evidence delivered.

scholarly journals Measurement properties of patient-reported outcome measures (PROMs) in hyperhidrosis: a systematic review

2021 ◽  
Author(s):  
Michaela Gabes ◽  
Helge Knüttel ◽  
Gesina Kann ◽  
Christina Tischer ◽  
Christian J. Apfelbacher
Keyword(s):  
Systematic Review ◽  
Clinical Trials ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Measurement Properties ◽  
High Quality ◽  
High Quality Evidence ◽  
Patient Reported ◽  
Quality Evidence

Abstract Purpose To critically appraise, compare and summarize the quality of all existing PROMs that have been validated in hyperhidrosis to at least some extend by applying the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) methodology. Thereby, we aim to give a recommendation for the use of PROMs in future clinical trials in hyperhidrosis. Methods We considered studies evaluating, describing or comparing measurement properties of PROMs as eligible. A systematic literature search in three big databases (MEDLINE, EMBASE and Web of Science) was performed. We assessed the methodological quality of each included study using the COSMIN Risk of Bias checklist. Furthermore, we applied predefined quality criteria for good measurement properties and finally, graded the quality of the evidence. Results Twenty-four articles reporting on 13 patient-reported outcome measures were included. Three instruments can be further recommended for use. They showed evidence for sufficient content validity and moderate- to high-quality evidence for sufficient internal consistency. The methodological assessment showed existing evidence gaps for eight other PROMs, which therefore require further validation studies to make an adequate decision on their recommendation. The Hyperhidrosis Disease Severity Measure-Axillary (HDSM-Ax) and the short-form health survey with 36 items (SF-36) were the only questionnaires not recommended for use in patients with hyperhidrosis due to moderate- to high-quality evidence for insufficient measurement properties. Conclusion Three PROMs, the Hyperhidrosis Quality of Life Index (HidroQoL), the Hyperhidrosis Questionnaire (HQ) and the Sweating Cognitions Inventory (SCI), can be recommended for use in future clinical trials in hyperhidrosis. Results obtained with these three instruments can be seen as trustworthy. Nevertheless, further validation of all three PROMs is desirable. Systematic review registration PROSPERO CRD42020170247

Analysis Of Factors Influencing Acupuncture Clinical Effects: A Systematic Review

2021 ◽  
Author(s):  
Yali Liu ◽  
Honglin Jiang ◽  
Xiaotong Li ◽  
Xingyue Yang
Keyword(s):  
Systematic Review ◽  
Individual Difference ◽  
Current Status ◽  
Clinical Effects ◽  
High Quality ◽  
Psychological States ◽  
Factors Influencing ◽  
High Quality Evidence ◽  
Stimulus Parameters ◽  
Quality Evidence

Background: Acupuncture therapy has been widely applied all around the world. But there still lacks high-quality evidence to evaluate its clinical effects, safety and cost-effectiveness, which seriously restricts its further promotion and development. Acupuncture, as an operational intervention, is more complex than drug therapy. Factors involved in the acupuncture operation process, such as individual and interventional factors, may affect clinical effects. Purpose:s Through this systematic review, we attempt to analyze the current status of studies about the key factors influencing clinical effects, so as to provide evidence for the design of acupuncture studies. Methods: A literature research was conducted in six databases until May, 2020. Studies were screened and assessed by two authors independently. Data extraction was made after screening. We extracted the basic information of these studies, including publishing years and countries, population and factors influencing clinical effects.Results: Through the initial search in these six database, 6404 records were retrieved. After duplication and screening, a total of 355 studies were finally included in the qualitative analysis. About 88.5% of these studies were conducted in China with increasing number in the past decades, covering neurological disorders, orthopedic disorders, obstetrical and gynecological diseases, digestive diseases and so on; 239 studies focused on stimulus parameters which may influence effects, accounting for 67.3%, and 128, 44, 39, 32, 15, 11 studies discussed acupoints, patients’ pathological states, individual difference, psychological states, deqi, and other factors separately. Conclusion: There are more and more studies focusing on factors influencing acupuncture clinical effects, including stimulus parameters, acupoints, individual difference, patient pathological and psychological states. Based on this systematic review, several ignored factors should be considered for future researches, and more scientifically and objectively high quality evidence should also be proved.

scholarly journals Cannabis and breastfeeding

2020 ◽  
Vol 25 (Supplement_1) ◽  
pp. S26-S28 ◽  
Author(s):  
Lisa Graves
Keyword(s):  
Health Care Providers ◽  
Small Sample ◽  
Adverse Outcomes ◽  
Care Providers ◽  
High Quality ◽  
High Quality Evidence ◽  
Small Sample Sizes ◽  
The Impact ◽  
Quality Evidence

Abstract Cannabis is one of the most commonly used substances in Canada with 15% of Canadians reporting use in 2019. There is emerging evidence that cannabis is linked to an impact on the developing brain in utero and adverse outcomes in infants, children, and adolescents. The impact of cannabis during breastfeeding has been limited by studies with small sample sizes, follow-up limited to 1 year and the challenge of separating prenatal exposure from that during breastfeeding. In the absence of high-quality evidence, health care providers need to continue to engage women in conversation about the potential concerns related to breastfeeding and cannabis use.

scholarly journals Mobile Technology Use and Its Association With Executive Functioning in Healthy Young Adults: A Systematic Review

2021 ◽  
Vol 12 ◽  
Author(s):  
Rachel E. Warsaw ◽  
Andrew Jones ◽  
Abigail K. Rose ◽  
Alice Newton-Fenner ◽  
Sophie Alshukri ◽  
...  
Keyword(s):  
Systematic Review ◽  
Decision Making ◽  
Executive Functioning ◽  
Mobile Technology ◽  
Systematic Reviews ◽  
Technology Use ◽  
Memory Performance ◽  
Mobile Technologies ◽  
Smartphone Use ◽  
The Impact

Introduction: Screen-based and mobile technology has grown at an unprecedented rate. However, little is understood about whether increased screen-use affects executive functioning (EF), the range of mental processes that aid goal attainment and facilitate the selection of appropriate behaviors. To examine this, a systematic review was conducted.Method: This systematic review is reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. A comprehensive literature search was conducted using Web of Science, MEDLINE, PsycINFO and Scopus databases to identify articles published between 2007 and March 2020, examining the use of mobile technologies on aspects of EF in healthy adults aged 18–35 years. In total 6079 articles were screened by title, and 39 screened by full text. Eight eligible papers were identified for inclusion. Our methods were pre-registered on the PROSPERO international prospective register of systematic reviews.Results: A total of 438 participants were included across the eight studies. Five of the eight studies examined more than one EF. Five studies measured inhibition, and four studies measured decision-making. Smartphone use was negatively associated with inhibition and decision-making. Working memory performance was found to be improved by increased time engaging in video games and by refraining from smartphone use prior to bedtime. Quality assessments indicated high risk of methodological biases across the studies and a low quality of evidence for determining the relationship between technology use and executive functioning.Conclusions: This review highlights the scarcity of the literature in this area. It presents a call for rigorous and objective research to further our understanding of the impact of mobile technology on different aspects of executive function.

scholarly journals Polysulfonate Resins in Hyperkalemia: A Systematic Review

2020 ◽  
Vol 7 ◽  
pp. 205435812096583
Author(s):  
Sheung Wing Sherwin Wong ◽  
Grace Zhang ◽  
Patrick Norman ◽  
Hasitha Welihinda ◽  
Don Thiwanka Wijeratne
Keyword(s):  
Systematic Review ◽  
Serum Potassium ◽  
Observational Studies ◽  
Primary Outcome ◽  
Case Series ◽  
Sodium Polystyrene Sulfonate ◽  
Polystyrene Sulfonate ◽  
High Quality ◽  
High Quality Evidence ◽  
Quality Evidence

Background: Hyperkalemia is a potentially life-threatening electrolyte abnormality defined as a serum potassium above the lab reference range (usually >5.0-5.5 mEq/L). Polystyrene resins, including sodium polystyrene sulfonate (SPS) and calcium polystyrene sulfonate (CPS), have long been used to treat hyperkalemia. Sodium polystyrene sulfonate/calcium polystyrene sulfonate act by exchanging a cation for potassium within the intestinal lumen. While SPS and CPS have been available since the 1960s, there are rising concerns about the validity of the data supporting its use and about serious adverse gastrointestinal effects. Objective: The objective of this systematic review was to quantify the efficacy and safety of polystyrene sulfonate resins (SPS/CPS) in the treatment of adults with hyperkalemia. This review focuses on the randomized control trial (RCT), interventional non-RCT, and observational data available on SPS/CPS use. Design: Systematic review. Setting: Any country of origin. Both inpatient and outpatient settings. Patients: Adults with hyperkalemia treated with polystyrene sulfonate resins. Measurements: The primary outcome was change in serum potassium. The secondary outcomes included adverse effects of SPS/CPS and prevention of recurrent hyperkalemia. Methods: We conducted a systematic review using Cochrane Library, EMBASE (1947-2019), and Medline (1946-2019) databases. Literature reviews, systematic reviews, case studies, case series, and editorial pieces were excluded. Included studies were assessed for risk of bias. Results: Four RCTs, 21 observational studies, and 5 quasi-experimental trials were included. A total of 212 351 patients were included. Two thousand and fifty-eight patients were studied for the primary outcome and 210 293 patients were studied for the secondary outcomes. Study designs were heterogeneous and not amenable to meta-analysis. Most studies included nonhemodialysis outpatients older than 65 years. Of the included studies, 22/25 (88%) demonstrated a reduction of serum potassium >0.5 mEq/L over the study period. The magnitude of reduction in serum potassium of potassium resin compared with placebo or matched controls in the 3 low-risk studies identified was 0.14 to 1.04 mEq/L. However, each study used different dosing regimens. Ten of 22 studies reported the effects of polystyrene resins on serum potassium within 24 hours. A few high-quality observational studies suggest an increased risk of serious adverse gastrointestinal events with a relative risk of 2.10 and a hazard ratio of 1.25 to 1.94; however, the absolute risk remains low. The incidence of adverse gastrointestinal events is 16 to 23 events per 1000 person-years. Limitations: We acknowledge several limitations in this study. Case studies and case series were excluded from the search results. Large case series may have been excluded despite having comparable sample sizes to studies included due to lack of a comparator and calculated estimates. Due to the heterogeneity of the studies, the data were unable to be meta-analyzed and as such the potassium-lowering effect of polystyrene sulfonate resins remains founded on small studies with potential confounders. Conclusions: This systematic review demonstrates a continued lack of high-quality evidence for the use of SPS/CPS in hyperkalemia. Studies investigated highly variable timelines and the most robust evidence for SPS/CPS use is in chronic hyperkalemia. While the absence of high-quality evidence does not exclude the possibility of benefit, prescribers must understand that the use of SPS/CPS in acute hyperkalemia is not supported by high-quality evidence. Trial registration: The protocol for this systematic review was not registered.

scholarly journals The effect of electronic audits and feedback in primary care and factors that contribute to their effectiveness: a systematic review

2020 ◽  
Vol 32 (10) ◽  
pp. 708-720
Author(s):  
Steve Van Den Bulck ◽  
David Spitaels ◽  
Bert Vaes ◽  
Geert Goderis ◽  
Rosella Hermens ◽  
...  
Keyword(s):  
Systematic Review ◽  
Primary Care ◽  
Cognitive Load ◽  
Medication Safety ◽  
Data Extraction ◽  
Cochrane Review ◽  
High Quality ◽  
Electronic Feedback ◽  
High Quality Evidence ◽  
Quality Evidence

Abstract Purpose The aim of this systematic review was (i) to assess whether electronic audit and feedback (A&F) is effective in primary care and (ii) to evaluate important features concerning content and delivery of the feedback in primary care, including the use of benchmarks, the frequency of feedback, the cognitive load of feedback and the evidence-based aspects of the feedback. Data sources The MEDLINE, Embase, CINAHL and CENTRAL databases were searched for articles published since 2010 by replicating the search strategy used in the last Cochrane review on A&F. Study selection Two independent reviewers assessed the records for their eligibility, performed the data extraction and evaluated the risk of bias. Our search resulted in 8744 records, including the 140 randomized controlled trials (RCTs) from the last Cochrane Review. The full texts of 431 articles were assessed to determine their eligibility. Finally, 29 articles were included. Data extraction Two independent reviewers extracted standard data, data on the effectiveness and outcomes of the interventions, data on the kind of electronic feedback (static versus interactive) and data on the aforementioned feedback features. Results of data synthesis Twenty-two studies (76%) showed that electronic A&F was effective. All interventions targeting medication safety, preventive medicine, cholesterol management and depression showed an effect. Approximately 70% of the included studies used benchmarks and high-quality evidence in the content of the feedback. In almost half of the studies, the cognitive load of feedback was not reported. Due to high heterogeneity in the results, no meta-analysis was performed. Conclusion This systematic review included 29 articles examining electronic A&F interventions in primary care, and 76% of the interventions were effective. Our findings suggest electronic A&F is effective in primary care for different conditions such as medication safety and preventive medicine. Some of the benefits of electronic A&F include its scalability and the potential to be cost effective. The use of benchmarks as comparators and feedback based on high-quality evidence are widely used and important features of electronic feedback in primary care. However, other important features such as the cognitive load of feedback and the frequency of feedback provision are poorly described in the design of many electronic A&F intervention, indicating that a better description or implementation of these features is needed. Developing a framework or methodology for automated A&F interventions in primary care could be useful for future research.

Antimicrobial prescribing for hospital-acquired pneumonia

2020 ◽  
Vol 81 (1) ◽  
pp. 1-3
Author(s):  
Tim Felton ◽  
Dan Wootton
Keyword(s):  
Decision Making ◽  
Antibiotic Prescribing ◽  
High Quality ◽  
Antimicrobial Prescribing ◽  
High Quality Evidence ◽  
Hospital Acquired Pneumonia ◽  
Hospital Acquired ◽  
The Impact ◽  
Inform Decision Making ◽  
Quality Evidence

The impact of hospital-acquired pneumonia and the pressure to reduce unnecessary antibiotic prescribing has lead to the publication of prescribing guidelines from the National Institute for Health and Care Excellence. This editorial gives an overview of the guidelines and emphasises the need for more high-quality evidence to inform decision making in this group of patients.

scholarly journals Eccentric Exercise Protocols for Patella Tendinopathy: Should we Really be Withdrawing Athletes from Sport? A Systematic Review

2012 ◽  
Vol 6 (1) ◽  
pp. 553-557 ◽  
Author(s):  
Adnan Saithna ◽  
Rajiv Gogna ◽  
Njalalle Baraza ◽  
Chetan Modi ◽  
Simon Spencer
Keyword(s):  
Systematic Review ◽  
Eccentric Exercise ◽  
Rehabilitation Program ◽  
Sufficient Evidence ◽  
High Quality ◽  
Exercise Rehabilitation ◽  
Rehabilitation Programs ◽  
High Quality Evidence ◽  
Patella Tendinopathy ◽  
Quality Evidence

The 2007 review by Visnes and Bahr concluded that athletes with patella tendinopathy should be withdrawn from sport whilst engaging in eccentric exercise (EE) rehabilitation programs. However, deprivation of sport is associated with a number of negative psychological and physiological effects. Withdrawal from sport is therefore a decision that warrants due consideration of the risk/benefit ratio. The aim of this study was to determine whether sufficient evidence exists to warrant withdrawal of athletes from sport during an eccentric exercise rehabilitation program. A systematic review of the literature was performed to identify relevant randomised trials. Data was extracted to determine whether athletes were withdrawn from sport, what evidence was presented to support the chosen strategy and whether this affected the clinical outcome. Seven studies were included. None of these reported high quality evidence to support withdrawal. In addition, three studies were identified in which athletes were not withdrawn from sport and still benefited from EE. This review has demonstrated that there is no high quality evidence to support a strategy of withdrawal from sport in the management of patella tendinopathy.

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