scholarly journals Electronic Medical Record–Based Case Phenotyping for the Charlson Conditions: Scoping Review (Preprint)

2020 ◽  
Author(s):  
Seungwon Lee ◽  
Chelsea Doktorchik ◽  
Elliot Asher Martin ◽  
Adam Giles D'Souza ◽  
Cathy Eastwood ◽  
...  
Keyword(s):  
Health Systems ◽  
Scoping Review ◽  
Clinical Pathways ◽  
Clinical Care ◽  
Data Access ◽  
The United States ◽  
Case Definitions ◽  
Services Research ◽  
Algorithm Development ◽  
Scoping Reviews

BACKGROUND Electronic medical records (EMRs) contain large amounts of rich clinical information. Developing EMR-based case definitions, also known as EMR phenotyping, is an active area of research that has implications for epidemiology, clinical care, and health services research. OBJECTIVE This review aims to describe and assess the present landscape of EMR-based case phenotyping for the Charlson conditions. METHODS A scoping review of EMR-based algorithms for defining the Charlson comorbidity index conditions was completed. This study covered articles published between January 2000 and April 2020, both inclusive. Embase (Excerpta Medica database) and MEDLINE (Medical Literature Analysis and Retrieval System Online) were searched using keywords developed in the following 3 domains: terms related to EMR, terms related to case finding, and disease-specific terms. The manuscript follows the Preferred Reporting Items for Systematic reviews and Meta-analyses extension for Scoping Reviews (PRISMA) guidelines. RESULTS A total of 274 articles representing 299 algorithms were assessed and summarized. Most studies were undertaken in the United States (181/299, 60.5%), followed by the United Kingdom (42/299, 14.0%) and Canada (15/299, 5.0%). These algorithms were mostly developed either in primary care (103/299, 34.4%) or inpatient (168/299, 56.2%) settings. Diabetes, congestive heart failure, myocardial infarction, and rheumatology had the highest number of developed algorithms. Data-driven and clinical rule–based approaches have been identified. EMR-based phenotype and algorithm development reflect the data access allowed by respective health systems, and algorithms vary in their performance. CONCLUSIONS Recognizing similarities and differences in health systems, data collection strategies, extraction, data release protocols, and existing clinical pathways is critical to algorithm development strategies. Several strategies to assist with phenotype-based case definitions have been proposed. CLINICALTRIAL

scholarly journals Electronic Medical Record–Based Case Phenotyping for the Charlson Conditions: Scoping Review

10.2196/23934 ◽  
2021 ◽  
Vol 9 (2) ◽  
pp. e23934
Author(s):  
Seungwon Lee ◽  
Chelsea Doktorchik ◽  
Elliot Asher Martin ◽  
Adam Giles D'Souza ◽  
Cathy Eastwood ◽  
...  
Keyword(s):  
Health Systems ◽  
Scoping Review ◽  
Clinical Pathways ◽  
Clinical Care ◽  
Data Access ◽  
The United States ◽  
Case Definitions ◽  
Services Research ◽  
Algorithm Development ◽  
Scoping Reviews

Background Electronic medical records (EMRs) contain large amounts of rich clinical information. Developing EMR-based case definitions, also known as EMR phenotyping, is an active area of research that has implications for epidemiology, clinical care, and health services research. Objective This review aims to describe and assess the present landscape of EMR-based case phenotyping for the Charlson conditions. Methods A scoping review of EMR-based algorithms for defining the Charlson comorbidity index conditions was completed. This study covered articles published between January 2000 and April 2020, both inclusive. Embase (Excerpta Medica database) and MEDLINE (Medical Literature Analysis and Retrieval System Online) were searched using keywords developed in the following 3 domains: terms related to EMR, terms related to case finding, and disease-specific terms. The manuscript follows the Preferred Reporting Items for Systematic reviews and Meta-analyses extension for Scoping Reviews (PRISMA) guidelines. Results A total of 274 articles representing 299 algorithms were assessed and summarized. Most studies were undertaken in the United States (181/299, 60.5%), followed by the United Kingdom (42/299, 14.0%) and Canada (15/299, 5.0%). These algorithms were mostly developed either in primary care (103/299, 34.4%) or inpatient (168/299, 56.2%) settings. Diabetes, congestive heart failure, myocardial infarction, and rheumatology had the highest number of developed algorithms. Data-driven and clinical rule–based approaches have been identified. EMR-based phenotype and algorithm development reflect the data access allowed by respective health systems, and algorithms vary in their performance. Conclusions Recognizing similarities and differences in health systems, data collection strategies, extraction, data release protocols, and existing clinical pathways is critical to algorithm development strategies. Several strategies to assist with phenotype-based case definitions have been proposed.

scholarly journals Learning health systems in primary care: a systematic scoping review

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Danielle M. Nash ◽  
Zohra Bhimani ◽  
Jennifer Rayner ◽  
Merrick Zwarenstein
Keyword(s):  
Primary Care ◽  
Quality Improvement ◽  
Health Systems ◽  
Scoping Review ◽  
Early Stage ◽  
Point Of Care ◽  
The United States ◽  
Stage Of Development ◽  
Integrated Health ◽  
Google Search

Abstract Background Learning health systems have been gaining traction over the past decade. The purpose of this study was to understand the spread of learning health systems in primary care, including where they have been implemented, how they are operating, and potential challenges and solutions. Methods We completed a scoping review by systematically searching OVID Medline®, Embase®, IEEE Xplore®, and reviewing specific journals from 2007 to 2020. We also completed a Google search to identify gray literature. Results We reviewed 1924 articles through our database search and 51 articles from other sources, from which we identified 21 unique learning health systems based on 62 data sources. Only one of these learning health systems was implemented exclusively in a primary care setting, where all others were integrated health systems or networks that also included other care settings. Eighteen of the 21 were in the United States. Examples of how these learning health systems were being used included real-time clinical surveillance, quality improvement initiatives, pragmatic trials at the point of care, and decision support. Many challenges and potential solutions were identified regarding data, sustainability, promoting a learning culture, prioritization processes, involvement of community, and balancing quality improvement versus research. Conclusions We identified 21 learning health systems, which all appear at an early stage of development, and only one was primary care only. We summarized and provided examples of integrated health systems and data networks that can be considered early models in the growing global movement to advance learning health systems in primary care.

scholarly journals Health Inequalities in Children and Adolescents: A Scoping Review of the Mediating and Moderating Effects of Family Characteristics

2021 ◽  
Vol 18 (15) ◽  
pp. 7739
Author(s):  
Miriam Blume ◽  
Petra Rattay ◽  
Stephanie Hoffmann ◽  
Jacob Spallek ◽  
Lydia Sander ◽  
...  
Keyword(s):  
Mental Health ◽  
Children And Adolescents ◽  
Health Inequalities ◽  
Scoping Review ◽  
The United States ◽  
Family Characteristics ◽  
Future Research ◽  
Childhood And Adolescence ◽  
Moderating Effects ◽  
Scoping Reviews

This scoping review systematically mapped evidence of the mediating and moderating effects of family characteristics on health inequalities in school-aged children and adolescents (6–18 years) in countries with developed economies in Europe and North America. We conducted a systematic scoping review following the PRISMA extension for Scoping Reviews recommendations. We searched the PubMed, PsycINFO and Scopus databases. Two reviewers independently screened titles, abstracts and full texts. Evidence was synthesized narratively. Of the 12,403 records initially identified, 50 articles were included in the synthesis. The included studies were conducted in the United States (n = 27), Europe (n = 18), Canada (n = 3), or in multiple countries combined (n = 2). We found that mental health was the most frequently assessed health outcome. The included studies reported that different family characteristics mediated or moderated health inequalities. Parental mental health, parenting practices, and parent-child-relationships were most frequently examined, and were found to be important mediating or moderating factors. In addition, family conflict and distress were relevant family characteristics. Future research should integrate additional health outcomes besides mental health, and attempt to integrate the complexity of families. The family characteristics identified in this review represent potential starting points for reducing health inequalities in childhood and adolescence.

scholarly journals Scoping review protocol: bladder cancer in Nigeria: what are the gaps in clinical care and research?

BMJ Open ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. e041894
Author(s):  
Joyce Kibaru ◽  
Pinky Kotecha ◽  
Abdulkarim Muhammad Iya ◽  
Beth Russell ◽  
Muzzammil Abdullahi ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Scoping Review ◽  
Low Income ◽  
Clinical Care ◽  
Grey Literature ◽  
Case Series ◽  
Cochrane Library ◽  
Future Research ◽  
Scoping Reviews ◽  
Local Risk

IntroductionBladder cancer (BC) is the 10th common cancer worldwide and ranks seventh in Nigeria. This scoping review aims to identify the gaps in clinical care and research of BC in Nigeria as part of the development of a larger national research programme aiming to improve outcomes and care of BC.Methods and analysisThis review will be conducted according to Arksey and O’Malley scoping review methodology framework. The following electronic databases will be searched: Medline (using the PubMed interface), Ovid Gateway (Embase and Ovid), Cochrane library and Open Grey literature. Two independent reviewers will screen titles and abstracts and subsequently screen full-text studies for inclusion, any lack of consensus will be discussed with a third reviewer. Any study providing insight into the epidemiology or treatment pathway of BC (RCTs, observations, case series, policy paper) will be included. A data chart will be used to extract relevant data from the included studies. Results will be reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews. A consultation process will be carried out with a multidisciplinary team of Nigerian healthcare professionals, patients and scientists.Ethics and disseminationThe results will be disseminated through peer-reviewed publications. By highlighting the key gaps in the literature, this review can provide direction for future research and clinical guidelines in Nigeria (and other low-income and middle-income countries), where BC is more prevalent due to local risk factors and healthcare settings.

scholarly journals How hospitalized patients evaluate and report their pain together with nurses: A scoping review

2021 ◽  
pp. 205715852110134
Author(s):  
Bente Dale Malones ◽  
Sindre Sylte Kallmyr ◽  
Vera Hage ◽  
Trude Fløystad Eines
Keyword(s):  
Scoping Review ◽  
Pain Assessment ◽  
Health Professionals ◽  
Clinical Care ◽  
Hospitalized Patients ◽  
Assessment Tools ◽  
Post Surgery ◽  
Reliable Assessment ◽  
Scoping Reviews ◽  
The Relationship

Pain assessment tools are often used by patients to report their pain and by health professionals to assess patients’ reported pain. Although valid and reliable assessment of pain is essential for high-quality clinical care, there are still many patients who experience inappropriate pain management. The aim of this scoping review is to examine an overview of how hospitalized patients evaluate and report their pain in collaboration with nurses. Systematic searches were conducted, and ten research articles were included using the PRISMA guidelines for scoping reviews. Content analysis revealed four main themes: 1) the relationship between the patient and nurse is an important factor of how hospitalized patients evaluate and report their post-surgery pain, 2) the patient’s feelings of inconsistency in how pain assessments are administered by nurses, 3) the challenge of hospitalized patients reporting post-surgery pain numerically, and 4) previous experiences and attitudes affect how hospitalized patients report their pain. Pain assessment tools are suitable for nurses to observe and assess pain in patients. Nevertheless, just using pain assessment tools is not sufficient for nurses to obtain a comprehensive clinical picture of each individual patient with pain.

scholarly journals Digital Phenotyping and Patient-Generated Health Data for Outcome Measurement in Surgical Care: A Scoping Review

2020 ◽  
Vol 10 (4) ◽  
pp. 282
Author(s):  
Prakash Jayakumar ◽  
Eugenia Lin ◽  
Vincent Galea ◽  
Abraham J. Mathew ◽  
Nikhil Panda ◽  
...  
Keyword(s):  
Scoping Review ◽  
Outcome Measurement ◽  
Clinical Care ◽  
Surgical Care ◽  
Health Data ◽  
The Body ◽  
Bibliographic Databases ◽  
Digital Phenotyping ◽  
Scoping Reviews ◽  
Patient Reported

Digital phenotyping—the moment-by-moment quantification of human phenotypes in situ using data related to activity, behavior, and communications, from personal digital devices, such as smart phones and wearables—has been gaining interest. Personalized health information captured within free-living settings using such technologies may better enable the application of patient-generated health data (PGHD) to provide patient-centered care. The primary objective of this scoping review is to characterize the application of digital phenotyping and digitally captured active and passive PGHD for outcome measurement in surgical care. Secondarily, we synthesize the body of evidence to define specific areas for further work. We performed a systematic search of four bibliographic databases using terms related to “digital phenotyping and PGHD,” “outcome measurement,” and “surgical care” with no date limits. We registered the study (Open Science Framework), followed strict inclusion/exclusion criteria, performed screening, extraction, and synthesis of results in line with the PRISMA Extension for Scoping Reviews. A total of 224 studies were included. Published studies have accelerated in the last 5 years, originating in 29 countries (mostly from the USA, n = 74, 33%), featuring original prospective work (n = 149, 66%). Studies spanned 14 specialties, most commonly orthopedic surgery (n = 129, 58%), and had a postoperative focus (n = 210, 94%). Most of the work involved research-grade wearables (n = 130, 58%), prioritizing the capture of activity (n = 165, 74%) and biometric data (n = 100, 45%), with a view to providing a tracking/monitoring function (n = 115, 51%) for the management of surgical patients. Opportunities exist for further work across surgical specialties involving smartphones, communications data, comparison with patient-reported outcome measures (PROMs), applications focusing on prediction of outcomes, monitoring, risk profiling, shared decision making, and surgical optimization. The rapidly evolving state of the art in digital phenotyping and capture of PGHD offers exciting prospects for outcome measurement in surgical care pending further work and consideration related to clinical care, technology, and implementation.

scholarly journals Exploring the prevalence of gaming disorder and internet gaming disorder: a rapid scoping review

2020 ◽  
Author(s):  
Nazia Darvesh ◽  
Amruta Radhakrishnan ◽  
Chantelle C Lachance ◽  
Vera Nincic ◽  
Jane P Sharpe ◽  
...  
Keyword(s):  
Scoping Review ◽  
Internet Gaming Disorder ◽  
Age Groups ◽  
The United States ◽  
Open Science ◽  
Geographic Region ◽  
Cochrane Library ◽  
Gaming Disorder ◽  
Internet Gaming ◽  
Scoping Reviews

Abstract Background : Internet gaming disorder (IGD) was included in the DSM-5 in 2013 as a condition requiring further research, and gaming disorder (GD) was included in the ICD-11 in 2018. Given the importance of including these conditions in diagnostic guidelines, a review was conducted to describe their prevalence. Methods : Using guidance from the Joanna Briggs Institute and the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR), we conducted a rapid scoping review. MEDLINE, Embase, PsycINFO, and the Cochrane library were searched for literature published from inception to July 2018. All review stages were pilot tested to calibrate reviewers. The titles/abstracts and full-text articles were screened by one reviewer to include quantitative primary studies that reported GD or IGD prevalence. Excluded citations were screened by a second reviewer to confirm exclusion. Charting was conducted by one reviewer and verified by another, to capture relevant data. Results were summarized descriptively in tables or text. Results : We assessed 5550 potentially relevant citations. No studies on GD were identified. We found 160 studies of various designs that used 35 different methods to diagnose IGD. Prevalence of IGD ranged from 0.21-57.50% in general populations, 3.20-91.00% in clinical populations, and 50.42-79.25% in populations undergoing intervention (severe cases). Most studies were conducted in the Republic of Korea (n=45), China (n=29), and the United States of America (n=20). Results are presented for severe IGD and by geographic region, gender/sex, and age groups (child, adolescent, adult). The five most frequently reported health-related variables were depression (67 times), internet addiction (54 times), anxiety (48 times), impulsiveness (37 times), and attention deficit hyperactivity disorder (24 times). Conclusions : Due to the variability in diagnostic approaches, knowledge users should interpret the wide IGD prevalence ranges with caution. In addition to further research on GD, consensus on the definition of IGD and how it is measured is needed, to better understand the prevalence of these conditions. Protocol registration : Open Science Framework https://osf.io/y2sr6/ , August 21 2018.

scholarly journals Elements of Trust in Digital Health Systems: Scoping Review (Preprint)

2018 ◽  
Author(s):  
Afua Adjekum ◽  
Alessandro Blasimme ◽  
Effy Vayena
Keyword(s):  
Health Care ◽  
Health Systems ◽  
Scoping Review ◽  
Service Provider ◽  
Digital Health ◽  
Digital Technologies ◽  
Data Access ◽  
Building Blocks ◽  
Sociodemographic Factors ◽  
Health Technologies

BACKGROUND Information and communication technologies have long become prominent components of health systems. Rapid advances in digital technologies and data science over the last few years are predicted to have a vast impact on health care services, configuring a paradigm shift into what is now commonly referred to as digital health. Forecasted to curb rising health costs as well as to improve health system efficiency and safety, digital health success heavily relies on trust from professional end users, administrators, and patients. Yet, what counts as the building blocks of trust in digital health systems has so far remained underexplored. OBJECTIVE The objective of this study was to analyze what relevant stakeholders consider as enablers and impediments of trust in digital health. METHODS We performed a scoping review to map out trust in digital health. To identify relevant digital health studies, we searched 5 electronic databases. Using keywords and Medical Subject Headings, we targeted all relevant studies and set no boundaries for publication year to allow a broad range of studies to be identified. The studies were screened by 2 reviewers after which a predefined data extraction strategy was employed and relevant themes documented. RESULTS Overall, 278 qualitative, quantitative, mixed-methods, and intervention studies in English, published between 1998 and 2017 and conducted in 40 countries were included in this review. Patients and health care professionals were the two most prominent stakeholders of trust in digital health; a third—health administrators—was substantially less prominent. Our analysis identified cross-cutting personal, institutional, and technological elements of trust that broadly cluster into 16 enablers (altruism, fair data access, ease of use, self-efficacy, sociodemographic factors, recommendation by other users, usefulness, customizable design features, interoperability, privacy, initial face-to-face contact, guidelines for standardized use, stakeholder engagement, improved communication, decreased workloads, and service provider reputation) and 10 impediments (excessive costs, limited accessibility, sociodemographic factors, fear of data exploitation, insufficient training, defective technology, poor information quality, inadequate publicity, time-consuming, and service provider reputation) to trust in digital health. CONCLUSIONS Trust in digital health technologies and services depends on the interplay of a complex set of enablers and impediments. This study is a contribution to ongoing efforts to understand what determines trust in digital health according to different stakeholders. Therefore, it offers valuable points of reference for the implementation of innovative digital health services. Building on insights from this study, actionable metrics can be developed to assess the trustworthiness of digital technologies in health care.

scholarly journals 10 years of EPOC: A scoping review of Emotiv’s portable EEG device

2020 ◽  
Author(s):  
Nikolas S Williams ◽  
Genevieve M McArthur ◽  
Nicholas A Badcock
Keyword(s):  
Signal Processing ◽  
Experimental Research ◽  
Scoping Review ◽  
User Authentication ◽  
Low Cost ◽  
The United States ◽  
Study Data ◽  
Emotional States ◽  
Scoping Reviews ◽  
Meta Analyses

AbstractBACKGROUNDCommercially-made low-cost electroencephalography (EEG) devices have become increasingly available over the last decade. One of these devices, Emotiv EPOC, is currently used in a wide variety of settings, including brain-computer interface (BCI) and cognitive neuroscience research.PURPOSEThe aim of this study was to chart peer-reviewed reports of Emotiv EPOC projects to provide an informed summary on the use of this device for scientific purposes.METHODSWe followed a five-stage methodological framework for a scoping review that included a systematic search using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) guidelines. We searched the following electronic databases: PsychINFO, MEDLINE, Embase, Web of Science, and IEEE Xplore. We charted study data according to application (BCI, clinical, signal processing, experimental research, and validation) and location of use (as indexed by the first author’s address).RESULTSWe identified 382 relevant studies. The top five publishing countries were the United States (n = 35), India (n = 25), China (n = 20), Poland (n = 17), and Pakistan (n = 17). The top five publishing cities were Islamabad (n = 11), Singapore (n = 10), Cairo, Sydney, and Bandung (n = 7 each). Most of these studies used Emotiv EPOC for BCI purposes (n = 277), followed by experimental research (n = 51). Thirty-one studies were aimed at validating EPOC as an EEG device and a handful of studies used EPOC for improving EEG signal processing (n = 12) or for clinical purposes (n = 11).CONCLUSIONSIn its first 10 years, Emotiv EPOC has been used around the world in diverse applications, from control of robotic limbs and wheelchairs to user authentication in security systems to identification of emotional states. Given the widespread use and breadth of applications, it is clear that researchers are embracing this technology.

scholarly journals A scoping review of clinical decision support tools that generate new knowledge to support decision making in real time

2020 ◽  
Vol 27 (12) ◽  
pp. 1968-1976
Author(s):  
Anna Ostropolets ◽  
Linying Zhang ◽  
George Hripcsak
Keyword(s):  
Decision Support ◽  
Real Time ◽  
Clinical Decision Support ◽  
Scoping Review ◽  
Clinical Care ◽  
Clinical Decision Support Systems ◽  
Clinical Decision ◽  
The United States ◽  
Quality Outcomes ◽  
New Knowledge

Abstract Objective A growing body of observational data enabled its secondary use to facilitate clinical care for complex cases not covered by the existing evidence. We conducted a scoping review to characterize clinical decision support systems (CDSSs) that generate new knowledge to provide guidance for such cases in real time. Materials and Methods PubMed, Embase, ProQuest, and IEEE Xplore were searched up to May 2020. The abstracts were screened by 2 reviewers. Full texts of the relevant articles were reviewed by the first author and approved by the second reviewer, accompanied by the screening of articles’ references. The details of design, implementation and evaluation of included CDSSs were extracted. Results Our search returned 3427 articles, 53 of which describing 25 CDSSs were selected. We identified 8 expert-based and 17 data-driven tools. Sixteen (64%) tools were developed in the United States, with the others mostly in Europe. Most of the tools (n = 16, 64%) were implemented in 1 site, with only 5 being actively used in clinical practice. Patient or quality outcomes were assessed for 3 (18%) CDSSs, 4 (16%) underwent user acceptance or usage testing and 7 (28%) functional testing. Conclusions We found a number of CDSSs that generate new knowledge, although only 1 addressed confounding and bias. Overall, the tools lacked demonstration of their utility. Improvement in clinical and quality outcomes were shown only for a few CDSSs, while the benefits of the others remain unclear. This review suggests a need for a further testing of such CDSSs and, if appropriate, their dissemination.

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