Digital rheumatology in the era of COVID-19: results of a national patient and physician survey

ObjectiveTo analyse the impact of the COVID-19 pandemic on rheumatic patients’ and rheumatologists’ usage, preferences and perception of digital health applications (DHAs).MethodsA web-based national survey was developed by the Working Group Young Rheumatology of the German Society for Rheumatology and the German League against Rheumatism. The prospective survey was distributed via social media (Twitter, Instagram and Facebook), QR code and email. Descriptive statistics were calculated, and regression analyses were performed to show correlations.ResultsWe analysed the responses of 299 patients and 129 rheumatologists. Most patients (74%) and rheumatologists (76%) believed that DHAs are useful in the management of rheumatic and musculoskeletal diseases (RMDs) and felt confident in their own usage thereof (90%; 86%). 38% of patients and 71% of rheumatologists reported that their attitude had changed positively towards DHAs and that their usage had increased due to COVID-19 (29%; 48%). The majority in both groups agreed on implementing virtual visits for follow-up appointments in stable disease conditions. The most reported advantages of DHAs were usage independent of time and place (76.6%; 77.5%). The main barriers were a lack of information on suitable, available DHAs (58.5%; 41.9%), poor usability (42.1% of patients) and a lack of evidence supporting the effectiveness of DHAs (23.2% of rheumatologists). Only a minority (<10% in both groups) believed that digitalisation has a negative impact on the patient–doctor relationship.ConclusionThe COVID-19 pandemic instigated an increase in patients’ and rheumatologists’ acceptance and usage of DHAs, possibly introducing a permanent paradigm shift in the management of RMDs.

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Digitazion in Gynaecology and Obstetrics in times of COVID-19: Results of a national survey (Preprint)

10.2196/preprints.30279 ◽

2021 ◽

Author(s):

Stefan Hertling ◽

Franziska Loos ◽

Doreen Hertling ◽

Isabel Graul ◽

Ingo Runnebaum

Keyword(s):

Paradigm Shift ◽

Care Management ◽

Negative Impact ◽

Digital Health ◽

Cross Sectional Study ◽

Cross Sectional ◽

Lack Of Information ◽

Gynecological Diseases ◽

Virtual Visits ◽

Health Applications

BACKGROUND In the COVID-19 pandemic, many consultations had to be canceled, postponed or switched to a virtual format. Telemedicine in patient care management could support physicians. OBJECTIVE The study analyses the Acceptance, Use and Barriers of digital health applications (DHAs) in patients with gynecological diseases and gynecologists in Germany. METHODS This prospective cross-sectional study was based on a survey of gynaecologists and patients in Germany during the COVID-19 pandemic. Descriptive statistics were calculated and regression analyses were performed to show correlations. RESULTS We analyzed the responses of 490 patients and 478 gynecologists. Most believed that DHAs are useful and felt confident in their own usage thereof. The majority in both groups agreed on implementing virtual visits in stable disease conditions. Only a minority (<10% in both groups) believed that digitalization has a negative impact on the patient–doctor relationship. Patients and physicians reported that their attitude had changed positively towards DHAs and that their usage had increased due to COVID-19. The most reported advantage of DHAs were usage independent of time. The main barriers were a lack of information on suitable, available DHAs and a lack of evidence supporting the effectiveness of DHAs. CONCLUSIONS The COVID-19 pandemic led to an increase in the acceptance and use of DHAs by patients and gynecologists, potentially leading to a permanent paradigm shift in the treatment of gynecological conditions.

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Changes in the global impact of COVID-19 on nuclear medicine departments during 2020: an international follow-up survey

European Journal of Nuclear Medicine and Molecular Imaging ◽

10.1007/s00259-021-05444-7 ◽

2021 ◽

Author(s):

Francesco Giammarile ◽

Roberto C. Delgado Bolton ◽

Noura El-Haj ◽

Lutz S. Freudenberg ◽

Ken Herrmann ◽

...

Keyword(s):

Nuclear Medicine ◽

Negative Impact ◽

Energy Agency ◽

Web Based ◽

Income Distributions ◽

The World ◽

Therapeutic Procedures ◽

Nuclear Medicine Procedures ◽

The Impact

Abstract Aim As a follow-up to the international survey conducted by the International Atomic Energy Agency (IAEA) in April 2020, this survey aims to provide a situational snapshot of the COVID-19 impact on nuclear medicine services worldwide, 1 year later. The survey was designed to determine the impact of the pandemic at two specific time points: June and October 2020, and compare them to the previously collected data. Materials and methods A web-based questionnaire, in the same format as the April 2020 survey was disseminated to nuclear medicine facilities worldwide. Survey data was collected using a secure software platform hosted by the IAEA; it was made available for 6 weeks, from November 23 to December 31, 2020. Results From 505 replies received from 96 countries, data was extracted from 355 questionnaires (of which 338 were fully completed). The responses came from centres across varying regions of the world and with heterogeneous income distributions. Regional differences and challenges across the world were identified and analysed. Globally, the volume of nuclear medicine procedures decreased by 73.3% in June 2020 and 56.9% in October 2020. Among the nuclear medicine procedures, oncological PET studies showed less of a decline in utilization compared to conventional nuclear medicine, particularly nuclear cardiology. The negative impact was also significantly less pronounced in high-income countries. A trend towards a gradual return to the pre-COVID-19 situation of the supply chains of radioisotopes, generators, and other essential materials was evident. Conclusion The year 2020 has a significant decrease in nuclear medicine diagnostic and therapeutic procedures as a result of the pandemic-related challenges. In June, the global decline recorded in the survey was greater than in October when the situation began to show improvement. However, the total number of procedures remained below those recorded in April 2020 and fell to less than half of the volumes normally carried out pre-pandemic.

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Feasibility of telemedicine in the management strategy of patients with lymphoma amid the COVID-19 pandemic in Spain, a prospective study (Preprint)

10.2196/preprints.34128 ◽

2021 ◽

Author(s):

Raul Cordoba ◽

Alberto Lopez-Garcia ◽

Daniel Morillo ◽

Maria-Angeles Perez-Saenz ◽

Elham Askari ◽

...

Keyword(s):

Prospective Observational Study ◽

Digital Health ◽

Hematologic Malignancies ◽

Patient Portal ◽

Health Strategy ◽

Potential Risk Factors ◽

Hospital Visits ◽

A Prospective Study ◽

The Impact

BACKGROUND Recurrent hospital visits were potential risk factors for COVID-19 contagion. OBJECTIVE The aims of this prospective observational study was to analyze the consequences of COVID-19 pandemic in the health care of patients with lymphoma and the impact of telemedicine strategies such as the patient portal in their management. METHODS All data were obtained from the electronic medical record (EMR). Variables such as age, sex, matter of the visit, use of patient’s portal, changes in management, impact in clinical trials and suffering from COVID-19 contagion were recorded. RESULTS 290 patients were attended in the lymphoma clinic accomplishing 437 appointments. The median age was 66 years (range 18-94), and 157 (54.13%) were male. Of them, 109 out of 290 (37.58%) were aged older then 70 years. Regarding number of visits, 214 patients (73.79%) had only 1 visit to the hospital. Only 23 patients (7.93%) didn’t have access to patient’s portal. During the follow-up, only 7 patients (2.41%) suffered from COVID-19, with a median age of 66 years (51-80). CONCLUSIONS Telemedicine such as patient’s portal are feasible strategies in the management of patients with lymphoma during the COVID-19 pandemic, with a reduction of in-person visits to hospital and a very low contagion rate. This experience allowed us to continue with a new digital health strategy in the follow up of patients with hematologic malignancies. CLINICALTRIAL Not registered.

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Changes in care in the fourth trimester in Ireland: 2010–2020

British Journal of Midwifery ◽

10.12968/bjom.2021.29.12.683 ◽

2021 ◽

Vol 29 (12) ◽

pp. 683-691

Author(s):

Jean Doherty ◽

Mary Brosnan ◽

Lucille Sheehy

Keyword(s):

Negative Impact ◽

Maternity Hospital ◽

Care Needs ◽

High Quality ◽

Midwifery Care ◽

Hospital Stays ◽

Current Context ◽

Discharge From Hospital ◽

The Impact

Background There has been a shift in maternity care over the past decade. The changes encountered by postnatal ward staff and the impact of these changes on women postnatally requires exploration. This study aimed to ascertain midwives' and healthcare assistants' perspectives of the changes in postnatal care and challenges to providing care in the current context. Methods This was a qualitative study involving two focus groups of 15 midwives and healthcare assistants from an Irish urban maternity hospital. The participants' responses were analysed thematically. Results Changes in women's clinical characteristics, including increased comorbidities and caesarean section rates, were highlighted as creating additional care needs. Furthermore, additional midwifery tasks and clinical protocols as well as shorter hospital stays leave little time for high-quality, woman-centred care. Participants highlighted a negative impact on maternal health from limited follow-up midwifery care in the community. Conclusions With additional midwifery duties and a reduction in time to complete them, additional community midwifery care is key to providing high-quality follow-on care after postnatal discharge from hospital.

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Venous and Lung Thromboembolism in the Context of Lung Cancer: Clinical Manifestations, Risk Factors and Prognosis

Acta Médica Portuguesa ◽

10.20344/amp.10260 ◽

2019 ◽

Vol 32 (10) ◽

pp. 647 ◽

Cited By ~ 1

Author(s):

Rosana Maia ◽

Inês Neves ◽

António Morais ◽

Henrique Queiroga

Keyword(s):

Lung Cancer ◽

Venous Thromboembolism ◽

Cancer Diagnosis ◽

Negative Impact ◽

Clinical Manifestations ◽

Research Subjects ◽

Lung Cancer Diagnosis ◽

The Impact ◽

The Relationship

Introduction: The relationship between cancer and thromboembolic events has been known for a long time. Lung and venous thromboembolism are frequent complications of lung cancer and its treatment, being a great cause of morbidity and mortality. We pretend to establish the relationship between lung and venous thromboembolism and lung cancer, describe patient characteristics and analyze the impact in the survival and prognosis.Material and Methods: It was a retrospective study. All research subjects were selected from lung cancer patients with a newly diagnosed lung and venous thromboembolism event admitted to Hospital S. João, between January 2008 and December 2013 and were followed until December 2014. Statistical analysis was performed with SPSS.Results: From the search, we obtained 113 patients. The majority was male, smokers or ex-smokers, and adenocarcinoma was the most frequent histologic type, being diagnosed mostly in advanced stages. We noticed that the median time between lung cancer diagnosis and lung venous thromboembolism was 2.9 months. In 24 patients (21.4%), the lung cancer diagnosis occurred after the lung and venous thromboembolism event and in 86 patients (76.8%), it occurred before the event. After a median follow up of 1.4 months, 107 (94.7%) patients died, 1 (0.9%) was lost to follow-up and 5 (4.4%) were still alive. The median survival rate was 1.5 months.Discussion: The diagnosis of lung and venous thromboembolism in patients with lung cancer is associated with bad prognosis. It occurs most frequently in patients with advanced disease, in the first months after lung cancer diagnosis and after beginning chemotherapy.Conclusion: Disease progression is an independent predictor with negative impact in overall survival.

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Prediction of outcome using positron emission tomography (PET) compared to standard response criteria and potential role in treatment decisions in diffuse large B-cell lymphoma (DLBCL) patients

Journal of Clinical Oncology ◽

10.1200/jco.2006.24.18_suppl.7565 ◽

2006 ◽

Vol 24 (18_suppl) ◽

pp. 7565-7565

Author(s):

M. Trneny ◽

U. Jaeger ◽

O. Belohlavek ◽

C. Skrabs ◽

J. Koren ◽

...

Keyword(s):

B Cell Lymphoma ◽

Response Criteria ◽

Limited Data ◽

Lack Of Information ◽

Positron Emission ◽

Standard Response ◽

The Impact ◽

Additional Therapy ◽

Valid Information

7565 Background: PET has been demonstrated to give valid information about viable tumor residua. There are however only limited data regarding the combination of classical response criteria with PET and there is a lack of information on the impact of additional therapy (add-Th) on the outcome of PET neg. or PET pos. pts. Methods: One hundred thirty-nine pts (median age 50y) with newly diagnosed DLBCL who were examined by PET during (after 2–4 cycles CHT - ‘early PET’) or/and at the end of therapy (‘end PET’) were analyzed retrospectively. IPI risk distribution were as follows: L 28%, LI 24%, IH 33% and H 15% pts. All pts were treated with anthracyclin based CHT. “Early PET” was performed in 84 pts. and “end PET” in 103 pts before add-Th, PET at both time points was performed in 48 pts. Add-Th (HDT with ASCT or/and radiotherapy), was given as planned or as a result of response evaluation (conventional methods - CT, trephine biopsy). No treatment modification was made on PET result only, except for 2 cases when planned RT was skipped because of PET neg. RT was performed in 59 pts (42.4%) and HDT with ASCT as consolidation in 54 pts (38.8%). Median follow up was 30 m. Results: CR or CRu was achieved after CHT in 102 (74%) pts, PR in 24 (17%) pts, stable or progress dis. in 13 (9%). ‘Early PET’ was neg. in 60% pts and ‘end PET’ was neg in 67% pts. PET neg. was achieved at least once in 97 (70%) pts, and PET pos. at least once was found in 50 pts (36%). The PFS at 30 m according to the combination of conventional and PET response was as follows: for CR PET-neg. pts 89%, for PR PET-neg. pts 90%, for CR PET-pos. pts 45% and for PR PET-pos. pts 64% (p=0.0001). OS was 93%, 63%, 90% and 83%, respect.(p=0.004). The analysis of impact of add-Th showed PFS at 30 m: for PET-neg pts with Add-Th 96%, for PET-neg. pts without Add-Th 82%. PET-pos. pts without Add-Th had a PFS of only 10% and PET-pos. pts with add-Th had PFS 58% (p=0.0001). The OS was 92%, 98%, 38% and 74% respect. (p=0.0001). Conclusions: Our data demonstrate that PET give more powerful information than standard response criteria. The second analysis support the the idea that pts with DLBCL in CR who remain PET pos. should undergo the additional therapy. Partial support: Grant MSM 0021620808 No significant financial relationships to disclose.

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Adult CHD patients under clinical follow-up have a similar quality of life to the general population in Malta

Cardiology in the Young ◽

10.1017/s1047951116001980 ◽

2016 ◽

Vol 27 (6) ◽

pp. 1051-1059

Author(s):

Maryanne Caruana ◽

Victor Grech

Keyword(s):

Quality Of Life ◽

Mental Health ◽

General Population ◽

Negative Impact ◽

Adult Survivors ◽

Cardiac Medication ◽

Self Reporting Questionnaire ◽

The Impact

AbstractBackgroundThe improved survival of patients born with CHD has led to increasing interest in research on quality of life of adult survivors. We report the findings of the first study in Malta carried out to investigate quality of life in adults with CHD under follow-up.MethodsA self-reporting questionnaire modelled on the basis of the European Health Interview Survey 2008, including questions on mental health and vitality, was administered to consecutive adult CHD outpatients, aged 16 years and over, between May, 2013 and May, 2014. Foreigners and patients with learning difficulties or cognitive impairment were excluded. Quality-of-life data were compared with that from 371 age- and sex-matched 2008 survey responders – general population cohort. The impact of congenital lesion complexity, hospitalisation in the preceding 12 months, arrhythmias, co-morbidities, and cardiac medication use on quality of life of the CHD cohort was also investigated.ResultsThere were a total of 120 patient responders (63 males; mean age 30.53, SD 12.77 years). Overall, there were no significant differences in mental health and vitality between patient and general population cohorts, although older patients had better mental health scores compared with age-matched controls. Within the adult CHD cohort, hospitalisation in the preceding 12 months was the only factor associated with a poorer quality of life.ConclusionsOverall, CHD has no negative impact on mental health and vitality in Maltese adult patients under follow-up. Patients needing frequent hospitalisations might warrant closer attention by clinical psychologists.

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Respondents’ Experiences of Completing a Retrospective Web-Based, Sexual Trauma Survey: Does a History of Sexual Victimization Equate With Risk for Harm?

Violence and Victims ◽

10.1891/0886-6708.27.6.991 ◽

2012 ◽

Vol 27 (6) ◽

pp. 991-1004 ◽

Cited By ~ 6

Author(s):

Nadia M. Wager

Keyword(s):

Sexual Victimization ◽

Research Participation ◽

Sexual Revictimization ◽

Web Based ◽

Personal Benefit ◽

History Of ◽

Original Survey ◽

Qualitative Responses ◽

The Impact

This study investigated respondents’ experiences of completing a retrospective web-based survey exploring sexual revictimization. The original survey provided a link to a separate mixed-methods survey assessing the impact of participation. Of the original 481 respondents, 234 completed this follow-up survey. Eighty percent were female and 52% reported histories of sexual victimization (SV). Newman, Willard, Sinclair, and Kaloupek’s (2001) Reactions to Research Participation Questionnaire was adapted to suit this web-based design, and several open-ended questions were included. The statistical analysis revealed that those who experienced SV reported higher levels of distress and personal benefit and were less likely to be inconvenienced by participation. However, higher levels of benefit did not always compensate for greater levels of distress, particularly for those with more recent and more extensive histories of SV. The thematic analysis of the qualitative responses is discussed and suggestions are offered for the design of more ethically sensitive research protocols and practices.

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Conservative management of CIN2p16 positive lesions in women with multiple HPV infection

10.21203/rs.3.rs-28366/v3 ◽

2020 ◽

Author(s):

Maria Teresa Bruno ◽

Guido Scalia ◽

Nazario Cassaro ◽

Maria Costanzo ◽

Sara Boemi

Keyword(s):

Laser Therapy ◽

Conservative Management ◽

Negative Impact ◽

Hpv Infection ◽

Multiple Infection ◽

Multiple Infections ◽

Hpv Test ◽

American Society ◽

The Impact

Abstract BackgroundAccording to the 2006 American Society for Colposcopy and Cervical Pathology guidelines, positive CIN2 p16 in women over the age of 25 should be managed with excisional treatment. However, excisional treatment is associated with physical, psychological and obstetric morbidity and can have a negative impact on sexual function. In our study we sought to identify a clear management strategy, addressing the impact of routine use of p16 immunohistochemistry in this population and identify appropriate criteria for patient selection with the aim of reducing over-treatment.MethodWe studied the medical records of 130 patients who had undergone laser therapy for CIN2. Each patient underwent colposcopy, biopsy and HPV test and were tested for p16 protein,. Patients were divided based on HPV infection into: single infections, multiple infections. All patients underwent ZTA laser therapy with follow-up (2-year follow-up ). Statistical analysis Contingency tables were created to evaluate the correlation between single, multiple and CIN2+ infections. Values with p <0.05 were considered statistically significant.ResultsSingle infections had a histological regression of 61.8% (21/34) and a histological persistence rate of 35.3% (12/34), which was greater than the multiple infection rate. The common characteristic that the women with persistence and progression had was the dimension of the lesion and the genotype 16. Ten cases of histological persistence and the only case of progression had one lesion greater than three quarters of the cervix.ConclusionsWith the progress of our understanding of the natural history of infection from human papillomavirus and the increasing use of colposcopy, thanks to the addition of HPV genotyping and the technique of immunohistochemistry, conservative management of these lesions is now possible

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Videocolaboração nas ações de Televisita no Hospital Militar de Área de São Paulo (HMASP) para apoio familiar no combate ao COVID-19: estudo de caso

10.5753/webmedia_estendido.2020.13078 ◽

2020 ◽

Author(s):

Mauricio M. M. Segobia ◽

Claudia Galindo Novoa ◽

Cicero Inácio Silva ◽

Guido Lemos de Souza Filho ◽

Jane de Almeida ◽

...

Keyword(s):

Digital Health ◽

Family Members ◽

Sao Paulo ◽

São Paulo ◽

Virtual Visits ◽

Psychosocial Effect ◽

The Impact

This article analyzes the experience of using a video collaboration tool, through the virtual visit (Televisita) strategy, at the São Paulo Army's Hospital (HMASP). The objective is to analyze the impact of the use of a system developed especially for this project, to reflect on the psychosocial effect that the virtual visit (Televisita) plays on patients and family members affected by COVID-19 and who are hospitalized in the HMASP facilities. The article also assesses and explores some strategies for using virtual visits that may be used in the Brazilian Army's HMASP and also describes future potentials in relation to video collaboration in digital health.

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