Lessons learnt during the implementation of a web-based triage tool for Dutch intensive care follow-up clinics

ObjectivesScreening for symptoms of postintensive care syndrome is based on a long list of questionnaires, filled out by the intensive care unit (ICU) survivor and manually reviewed by the health professional. This is an inefficient and time-consuming process. The aim of this study was to evaluate the feasibility of a web-based triage tool and to compare the outcomes from web-based questionnaires to those from paper-based questionnaires.DesignA mixed-methods study.SettingNine Dutch ICU follow-up clinics.Participants221 ICU survivors and 14 health professionals.InterventionsA web-based triage tool was implemented by nine ICU follow-up clinics. End users, that is, health professionals were interviewed in order to evaluate the feasibility of the triage tool. ICU survivors were invited to fill out web-based questionnaires 3 months after hospital discharge.Primary outcomesOutcomes of the questionnaires were merged with clinical data from a national quality registry to assess the differences in outcomes between paper-based and web-based questionnaires.Results221 ICU survivors received an invitation to fill out questionnaires, 93 (42.1%) survivors did not respond to the invitation. Respondents to the web-based questionnaires (n=54) were significantly younger and had a significantly longer ICU stay than those who preferred the paper-based questionnaires (n=74). The prevalence of mental, physical and nutritional problems was high, although comparable between the groups. Health professionals’ interviews revealed that the software was complex to use (n=8) and although emailing survivors is very convenient, not all survivors have an email address (n=7).ConclusionsWeb-based screening software has major benefits compared with paper-based screening. However, implementation has shown to be rather difficult and there are important barriers to consider. Although different in age, the health status is comparable between the users of the web-based questionnaire and paper-based questionnaire.

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OC02.02: First trimester examination with a web-based system. Experiences from the Swedish National Quality Registry for prenatal diagnosis

Ultrasound in Obstetrics and Gynecology ◽

10.1002/uog.9102 ◽

2011 ◽

Vol 38 (S1) ◽

pp. 3-3

Author(s):

P. Conner ◽

A. Marsk ◽

M. Kublickas ◽

H. Almström

Keyword(s):

Prenatal Diagnosis ◽

First Trimester ◽

Web Based ◽

Quality Registry ◽

National Quality ◽

Web Based System ◽

National Quality Registry

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Treatment outcomes for eating disorders in Sweden: data from the national quality registry

BMJ Open ◽

10.1136/bmjopen-2018-024179 ◽

2019 ◽

Vol 9 (1) ◽

pp. e024179 ◽

Cited By ~ 4

Author(s):

Per Södersten ◽

Ulf Brodin ◽

Jennie Sjöberg ◽

Modjtaba Zandian ◽

Cecilia Bergh

Keyword(s):

Eating Disorders ◽

Average Rate ◽

Eating Behaviour ◽

Quality Registry ◽

Number Of Patients ◽

National Quality ◽

Remission Rates ◽

Lost To Follow Up ◽

National Quality Registry

ObjectiveTo report the outcomes of eating disorders treatment in Sweden in 2012–2016.DesignThe number of patients treated and the number of patients not fulfilling an eating disorders diagnosis (remission) at 1 year of follow-up at the clinics listed in the National Quality Registry for Eating Disorders Treatment were analysed. The published outcomes at three clinics, which used survival analysis to estimate outcomes, were compared with their outcomes in the registry. Outcomes at the three biggest clinics were compared.SettingAll eating disorders clinics.ParticipantsAll patients treated at eating disorders clinics.InterventionCognitive–behavioural therapy at most clinics and normalisation of eating behaviour at the three clinics with published outcomes.Outcome measureProportion of patients in remission.ResultsAbout 2600 patients were treated annually, fewer than half were followed up and remission rates decreased from 21% in 2014 to 14% in 2016. Outcomes, which differed among clinics and within clinics over time, have been publicly overestimated by excluding patients lost to follow-up. The published estimated rate of remission at three clinics that treated 1200 patients in 1993–2011 was 27%, 28% and 40% at 1 year of follow-up. The average rate of remission over the three last years at the biggest of these clinics was 36% but decreased from 29% and 30% to 16 and 14% at the two other of the biggest clinics.ConclusionsWith more than half the patients lost to follow-up and no data on relapse in the National Quality Registry, it is difficult to estimate the effects of eating disorders treatment in Sweden. Analysis of time to clinically significant events, including an extended period of follow-up, has improved the quality of the estimates at three clinics. Overestimation of remission rates has misled healthcare policies. The effect of eating disorders treatment has also been overestimated internationally.

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CLINCAL EFFECTIVENESS OF GOLIMUMAB IN CROHN’S DISEASE – AN OBSERVATIONAL STUDY BASED ON THE SWEDISH NATIONAL QUALITY REGISTRY FOR INFLAMMATORY BOWEL DISEASE

10.26226/morressier.59a6b348d462b80290b54e3d ◽

2017 ◽

Author(s):

Sara Rundquist

Keyword(s):

Inflammatory Bowel Disease ◽

Crohn’S Disease ◽

Crohn's Disease ◽

Observational Study ◽

Bowel Disease ◽

Quality Registry ◽

National Quality ◽

Inflammatory Bowel ◽

National Quality Registry

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A Suite of Mobile Conversational Agents for Daily Stress Management (Popbots): Mixed Methods Exploratory Study (Preprint)

10.2196/preprints.25294 ◽

2020 ◽

Author(s):

Matthew Louis Mauriello ◽

Nantanick Tantivasadakarn ◽

Marco Antonio Mora-Mendoza ◽

Emmanuel Thierry Lincoln ◽

Grace Hon ◽

...

Keyword(s):

Stress Management ◽

Design Guidelines ◽

Coping Resources ◽

Rank Test ◽

Depression Symptoms ◽

Conversational Agents ◽

Daily Stress ◽

Web Based ◽

The Web

BACKGROUND Approximately 60%-80% of the primary care visits have a psychological stress component, but only 3% of patients receive stress management advice during these visits. Given recent advances in natural language processing, there is renewed interest in mental health chatbots. Conversational agents that can understand a user’s problems and deliver advice that mitigates the effects of daily stress could be an effective public health tool. However, such systems are complex to build and costly to develop. OBJECTIVE To address these challenges, our aim is to develop and evaluate a fully automated mobile suite of shallow chatbots—we call them Popbots—that may serve as a new species of chatbots and further complement human assistance in an ecosystem of stress management support. METHODS After conducting an exploratory Wizard of Oz study (N=14) to evaluate the feasibility of a suite of multiple chatbots, we conducted a web-based study (N=47) to evaluate the implementation of our prototype. Each participant was randomly assigned to a different chatbot designed on the basis of a proven cognitive or behavioral intervention method. To measure the effectiveness of the chatbots, the participants’ stress levels were determined using self-reported psychometric evaluations (eg, web-based daily surveys and Patient Health Questionnaire-4). The participants in these studies were recruited through email and enrolled on the web, and some of them participated in follow-up interviews that were conducted in person or on the web (as necessary). RESULTS Of the 47 participants, 31 (66%) completed the main study. The findings suggest that the users viewed the conversations with our chatbots as helpful or at least neutral and came away with increasingly positive sentiment toward the use of chatbots for proactive stress management. Moreover, those users who used the system more often (ie, they had more than or equal to the median number of conversations) noted a decrease in depression symptoms compared with those who used the system less often based on a Wilcoxon signed-rank test (W=91.50; Z=−2.54; <i>P</i>=.01; <i>r</i>=0.47). The follow-up interviews with a subset of the participants indicated that half of the common daily stressors could be discussed with chatbots, potentially reducing the burden on human coping resources. CONCLUSIONS Our work suggests that suites of shallow chatbots may offer benefits for both users and designers. As a result, this study’s contributions include the design and evaluation of a novel suite of shallow chatbots for daily stress management, a summary of benefits and challenges associated with random delivery of multiple conversational interventions, and design guidelines and directions for future research into similar systems, including authoring chatbot systems and artificial intelligence–enabled recommendation algorithms.

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Physicians’ Choice in Using Internet and Fax for Patient Recruitment and Follow-up in a Randomized Controlled Trial

Methods of Information in Medicine ◽

10.1055/s-0038-1633867 ◽

2004 ◽

Vol 43 (03) ◽

pp. 268-272 ◽

Cited By ~ 5

Author(s):

S. Morita ◽

T. Fukui ◽

J. Sakamoto ◽

M. Rahman

Keyword(s):

Randomized Controlled Trial ◽

Odds Ratio ◽

Controlled Trial ◽

Data Entry ◽

Regression Analyses ◽

Multivariate Logistic Regression ◽

Web Based ◽

Randomized Controlled ◽

The Web

Summary Objective: To examine the physicians’ preference between Web and fax-based remote data entry (RDE) system for an ongoing randomized controlled trial (RCT) in Japan. Methods: We conducted a survey among all the collaborating physicians (n = 512) of the CASE-J (Candesartan Antihypertensive Survival Evaluation in Japan) trial, who have been recruiting patients and sending follow-up data using the Web or a fax-based RDE system. The survey instrument assessed physicians’ choice between Web and fax-based RDE systems, their practice pattern, and attitudes towards these two modalities. Results: A total of 448 (87.5%) responses were received. The proportions of physicians who used Web, fax, and the combination of these two were 45.9%, 33.3% and 20.8%, respectively. Multivariate logistic regression analyses revealed that physicians 55 years or younger [odds ratio (OR) = 1.9, 95% confidence interval (CI) = 1.1-3.3] and regular users of computers (OR = 4.2, 95% CI = 2.1-8.2) were more likely to use the Web-based RDE system. Conclusions: This information would be useful in designing an RCT with a Web-based RDE system in Japan and abroad.

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