scholarly journals Determinants of Longitudinal Adherence in Smartphone-Based Self-Tracking for Chronic Health Conditions

2021 ◽  
Vol 5 (1) ◽  
pp. 1-24
Author(s):  
Simon L. Jones ◽  
William Hue ◽  
Ryan M. Kelly ◽  
Rosemarie Barnett ◽  
Violet Henderson ◽  
...  
Keyword(s):  
Clinical Decision Making ◽  
Clinical Decision ◽  
Health Conditions ◽  
Smartphone Apps ◽  
Data Logging ◽  
Activity Tracker ◽  
Area Of Interest ◽  
Health Tracking ◽  
Tracking Devices ◽  
Insight Into

The use of interactive mobile and wearable technologies for understanding and managing health conditions is a growing area of interest for patients, health professionals and researchers. Self-tracking technologies such as smartphone apps and wearable devices for measuring symptoms and behaviours generate a wealth of patient-centric data with the potential to support clinical decision making. However, the utility of self-tracking technologies for providing insight into patients' conditions is impacted by poor adherence with data logging. This paper explores factors associated with adherence in smartphone-based tracking, drawing on two studies of patients living with axial spondyloarthritis (axSpA), a chronic rheumatological condition. In Study 1, 184 axSpA patients used the uMotif health tracking smartphone app for a period of up to 593 days. In Study 2, 108 axSpA patients completed a survey about their experience of using self-tracking technologies. We identify six significant correlates of self-tracking adherence, providing insight into the determinants of tracking behaviour. Specifically, our data provides evidence that adherence correlates with the age of the user, the types of tracking devices that are being used (smartphone OS and physical activity tracker), preferences for types of data to record, the timing of interactions with a self-tracking app, and the reported symptom severity of the user. We discuss how these factors may have implications for those designing, deploying or using mobile and wearable tracking technologies to support monitoring and management of chronic diseases.

scholarly journals Blood transfusion prescribing in the ACT: an insight into clinical decision making

2005 ◽  
Vol 29 (2) ◽  
pp. 240 ◽  
Author(s):  
Philip J Crispin ◽  
Bethany J Crowe ◽  
Anne M McDonald
Keyword(s):  
Decision Making ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Early Discharge ◽  
Organisation Of Care ◽  
Metropolitan Hospital ◽  
Loss Of Appetite ◽  
Insight Into ◽  
Structured Questionnaire

This study aimed to determine the perspectives of a group of patients categorised as ?long-stay outliers? at a large South Australian metropolitan hospital about aspects of organisation of care and the perceived impact of long-term hospitalisation. Nineteen patients were interviewed using a semi-structured questionnaire. Eighty-nine percent of participants stated that they had no knowledge of how long they were to be in hospital. Forty-two percent indicated that they did not know when they would be discharged from hospital. This was of concern, especially considering the vulnerability of this patient group and the known benefits of patient involvement in decision making and the improvements this can make to health outcomes and early discharge. Participants indicated concern about sleep deprivation, diet, ability to return to paid employment, and missing their family as the main areas of impact of their long hospitalisation. Concerns about being discharged from hospital included: apprehension as to whether they were well enough to leave; the recurrence of infection; whether they would be able to sleep well when they got home; their recent loss of appetite and associated weight loss; mobility concerns; and what supports they would have when they were discharged home. All these issues require staff to be more patient and family-centred in their approach to preparing for discharge.

Diagnostic conversations: Clinical Decision Making in surgery – Part 2

Diagnosis ◽  
2014 ◽  
Vol 1 (2) ◽  
pp. 189-193 ◽  
Author(s):  
David Allan Watters ◽  
Spencer Wynyard Beasley ◽  
Wendy Crebbin
Keyword(s):  
Decision Making ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Learning Opportunities ◽  
Clinical Decisions ◽  
Decision Making Processes ◽  
Royal Australasian College ◽  
Insight Into ◽  
Made In

AbstractProceduralists who fail to review their decision making are unlikely to learn from their experiences, irrespective of whether the operative outcome is successful or not. Teaching junior surgeons to develop ‘insight’ into their own decision making has long been a challenge. Surgeons and staff of the Royal Australasian College of Surgeons worked together to develop a model to help explain the processes around clinical decision making and incorporated this model into a Clinical Decision Making (CDM) training course. In this course, faculty apply the model to specific surgical cases, within the model’s framework of how clinical decisions are made; thus providing an opportunity to identify specific decision making processes as they occur and to highlight some of the learning opportunities they provide. The conversation in this paper illustrates the kinds of case-based interactions which typically occur in the development and teaching of the CDM course.The focus in this, the second of two papers, is on reviewing post-operative clinical decisions made in relation to one case, to improve the quality of subsequent decision making.

scholarly journals Use and impact of smartphone apps in mental health

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
A Amerio ◽  
A Scardoni ◽  
L Bellini ◽  
S Salvati ◽  
S Buttigieg ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Disorders ◽  
Clinical Decision Making ◽  
Healthcare Providers ◽  
Experimental Studies ◽  
Clinical Decision ◽  
Future Research ◽  
Smartphone Apps ◽  
Health Apps ◽  
The Impact

Abstract As smartphone usage is more and more ubiquitous, the app market is flourishing in all fields, including health. Indeed, the availability and use of smartphone apps (SAs) in health has exponentially grown in recent years. It has been estimated that in 2018 there were over 97,000 health apps available and that, 15% and 8% of US phone users aged 18-29 and 30-49 years respectively had health apps installed on their mobile devices. Health apps might potentially support people health paths in multiple ways: channeling health education, enabling personal health data tracking, self-monitoring and goals setting, facilitating access to health records or compliance to treatment, fostering effective communication with healthcare providers and health services, as well as supporting clinical decision-making. Despite such large potential, still scant evidence is available on the impact of SAs on clinical outcomes in different fields of medicine, including mental health. With an estimated prevalence of around 450 million people currently suffering from mental disorders and 1 in 4 people in the world affected at some point in own life, mental disorders are a leading cause of ill-health and disability worldwide whose prevention and care might be enhanced by mHealth technology. The general aim of the presentation is to provide an overview on the use and impact of SAs in the field of mental health. Specific objectives are: i) to present a conceptual framework on how SAs might support mental disorders prevention, diagnosis and treatment, ii) to report on SAs use in mental health in different settings, iii) to collect and pool available evidence from observational and experimental studies on the impact of SAs use on different mental health outcomes, iv) to explore the quality, effectiveness and attributes of top-rated smartphone mental health apps and lastly, v) to suggest gaps in knowledge to be filled by future research.

scholarly journals FUTURES: Forecasting the Unexpected Transfer to Upgraded Resources in Sepsis

2019 ◽  
Vol 8 (1) ◽  
pp. 187-191
Author(s):  
Alexa Profozich ◽  
Trevor Sytsma ◽  
Ryan Arnold ◽  
Kristen Miller ◽  
Muge Capan
Keyword(s):  
Decision Making ◽  
Emergency Department ◽  
Clinical Decision Making ◽  
Point Of Care ◽  
Initial Point ◽  
Clinical Decision ◽  
Sepsis Management ◽  
Insight Into

Sepsis is one of the most deadly and costly diseases. The Emergency Department (ED) is the initial point of care for most patients who become hospitalized due to sepsis. Quantifying the accuracy of ED clinician forecasting regarding patients’ clinical trajectories and outcomes can provide insight into clinical decision making and inform sepsis management.

scholarly journals CyberKnife stereotactic radiosurgery for the treatment of symptomatic vertebral hemangiomas: a single-institution experience

2017 ◽  
Vol 42 (1) ◽  
pp. E13 ◽  
Author(s):  
Michael Zhang ◽  
Yi-Ren Chen ◽  
Steven D. Chang ◽  
Anand Veeravagu
Keyword(s):  
Stereotactic Radiosurgery ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Lesion Size ◽  
Neurological Deficits ◽  
Radiographic Outcomes ◽  
Relative Rarity ◽  
Vertebral Hemangiomas ◽  
Future Patient ◽  
Insight Into

OBJECTIVE Symptomatic vertebral hemangiomas (SVHs) are a very rare pathology that can present with persistent pain or neurological deficits that warrant surgical intervention. Given the relative rarity and difficulty in assessment, the authors sought to present a dedicated series of SVHs treated using stereotactic radiosurgery (SRS) to provide insight into clinical decision making. METHODS A retrospective review of a single institution's experience with hypofractionated radiosurgery for SVH from 2004 to 2011 was conducted to determine the clinical and radiographic outcomes following SRS treatment. The authors report and analyze the treatment course of 5 patients with 7 lesions, 2 of which were treated primarily by SRS. RESULTS Of the 5 patients studied, 4 presented with a chief complaint of pain refractory to conservative measures. Three patients reported dysesthesias, and 2 reported upper-extremity weakness. Following radiosurgery, 4 of 5 patients exhibited improvement in their primary symptoms (3 for pain and 1 for weakness), achieving a clinical response after a mean period of 1 year. In 2 cases there was 20%–40% reduction in lesion size in the most responsive dimension as noted on images. All treatments were well tolerated. CONCLUSIONS SRS for SVH is a safe and feasible treatment strategy, comparable to prior radiotherapy studies, and in select cases may successfully confer delayed decompressive effects. Additional investigation will determine future patient selection and how conformal SRS treatment can best be administered.

Beyond the Fingerstick: Complications of Diabetes in the Acutely Ill Patient with Covid-19 with Lessons from Translation Biology and Therapeutics

2021 ◽  
Vol 8 (1) ◽  
Author(s):  
Nashawi M ◽  
◽  
Ahmed M ◽  
Jarrar Y ◽  
Abualfoul M ◽  
...  
Keyword(s):  
Clinical Decision Making ◽  
Contemporary Literature ◽  
Clinical Decision ◽  
Medical Interventions ◽  
Biomedical Equipment ◽  
Decision Making Capacity ◽  
Clinical Literature ◽  
Acute Diabetes ◽  
Hyperosmolar Hyperglycemic State ◽  
Insight Into

The affliction that the Coronavirus Disease 2019 (COVID-19) pandemic has placed on the infrastructure of healthcare institutions across the globe permeates to the level of the provider, hampering clinical decision-making capacity and capability. Associated with the latter has been unprecedented, sweeping changes in biomedical equipment manufacturing, triage dynamics, and implementation of medical interventions in a landscape replete with clinical literature attempting to characterize features in COVID-19 patients. Preliminary assessments into the elements of the SARS-CoV-2 virus (the strain of coronavirus responsible for COVID-19) in addition to the delineation of patient flux pertaining to COVID-19 has identified diabetes as a prevalent comorbidity with increased mortality and increased disease burden in the acutely ill. The volume of patients with COVID-19 superimposed upon complicated diabetes exemplifies that insight into this association offers an expanded perspective of diabetes mellitus. Moreover, given the extensive organ compromise seen in COVID-19 in addition to the established notion that diabetes is a systemic syndrome of metabolism, an appraisal of the literature of medical management and precursory findings serve as bearings that help render clinical principles into viable treatments. In this review we investigate the array of contemporary literature surrounding COVID-19 with a perspective centered upon the management of acute diabetes complications, namely diabetic ketoacidosis and hyperosmolar hyperglycemic state, with emphases into translational biology and pharmacotherapeutics.

scholarly journals Viral load testing and the use of test results for clinical decision making for HIV treatment in Cameroon: An insight into the clinic-laboratory interface

PLoS ONE ◽  
2018 ◽  
Vol 13 (6) ◽  
pp. e0198686 ◽  
Author(s):  
George Awungafac ◽  
Elvis T. Amin ◽  
Akemfua Fualefac ◽  
Noah F. Takah ◽  
Lucy A. Agyingi ◽  
...  
Keyword(s):  
Decision Making ◽  
Viral Load ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Hiv Treatment ◽  
Load Testing ◽  
Test Results ◽  
Viral Load Testing ◽  
Insight Into

scholarly journals Factors That Influence the Clinical Decision Making of Novice and Experienced Physical Therapists

2011 ◽  
Vol 91 (1) ◽  
pp. 87-101 ◽  
Author(s):  
Susan Flannery Wainwright ◽  
Katherine F. Shepard ◽  
Laurinda B. Harman ◽  
James Stephens
Keyword(s):  
Decision Making ◽  
Clinical Decision Making ◽  
Structure Learning ◽  
Physical Therapists ◽  
Physical Therapist ◽  
Inpatient Rehabilitation ◽  
Clinical Decision ◽  
Novice Learners ◽  
Multiple Data ◽  
Insight Into

Background The depth and breadth of prior experience informs clinical decision making in novice and experienced physical therapist clinicians. Objectives The aims of this research were to identify differences in clinical decision-making abilities and processes between novice and experienced physical therapist clinicians and to develop a model of the factors that influence clinical decision making. Design Qualitative research methods and grounded theory were used to gain insight into the factors and experiences that inform clinical decision making. Methods Three participant pairs (each pair consisted of 1 novice physical therapist and 1 experienced physical therapist) were purposively selected from 3 inpatient rehabilitation settings. Case summaries from each participant provided the basis for within- and across-case analyses. The credibility of the results was established through checking of the case summaries by the participants, presentation of low-inference data, and triangulation across multiple data sources and within and across participant groups. Results The factors that influenced clinical decision making were categorized as informative or directive. Novice participants relied more on informative factors, whereas experienced participants were more likely to rely on directive factors. An intermediate effect beyond novice practice was observed. Conclusions The results of this study may be used by educators and employers to develop and structure learning experiences and mentoring opportunities for students and novice learners with the aim of facilitating the development of skills and abilities consistent with expert clinical decision making.

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