scholarly journals Domains and methods used to assess home telemonitoring scalability: A systematic review (Preprint)

2021 ◽  
Author(s):  
Salome Azevedo ◽  
Teresa Cipriano Rodrigues ◽  
Ana Rita Londral
Keyword(s):  
Narrative Analysis ◽  
Care Delivery ◽  
Meta Analysis ◽  
Scale Up ◽  
Real Life ◽  
Technological Infrastructure ◽  
Intervention Delivery ◽  
Home Telemonitoring ◽  
Pilot Intervention ◽  
Future Work

BACKGROUND COVID-19 pandemic catalyzed the adoption of home telemonitoring to cope with social distance challenges. However, policy-makers and practitioners did not have enough information to decide which pilot intervention they should disseminate into mainstream care delivery. OBJECTIVE This review aims to identify the domains and methods used in peer-reviewed studies under real-life conditions for evaluating home telemonitoring-based interventions’ scalability. METHODS The authors followed Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines and used multiple databases (PubMed, Scopus, Web of Science, and EconLite). Lastly, the authors conducted a narrative analysis to identify domains and methods to support scalability assessment. RESULTS The authors identified 13 articles focused on the ability to expand a home telemonitoring intervention. While most of the studies considered the problem, intervention, effectiveness, costs, and benefits of the intervention delivery as relevant domains for scalability assessment, studies did not always consider domains such as socio-political context, setting, workforce, and technological infrastructure. Researchers used different methods to assess effectiveness, costs, benefits, and acceptability. Although cost-effectiveness was the most common method, researchers evaluated the costing domain using seven cost analysis methods. CONCLUSIONS The review suggests that researchers select the same domains when assessing scalability, to the detriment of others also relevant. Additionally, studies use different methods to evaluate the same domain, which makes comparison difficult. Future work should examine the minimum required domains and suggest methods that would enable comparison among studies and provide better support for decision-making on whether to scale-up them.

Collaborating for Our Future

2018 ◽  
Author(s):  
Barbara Gray ◽  
Jill Purdy
Keyword(s):  
Management Education ◽  
Care Delivery ◽  
Scale Up ◽  
Collaborative Governance ◽  
Comprehensive Understanding ◽  
Theoretical Understanding ◽  
Effect Change ◽  
Working Together ◽  
Vantage Points ◽  
Multistakeholder Partnerships

Organizations turn to multistakeholder partnerships (MSPs) to meet challenges they cannot handle alone. By tapping diverse stakeholders’ resources, MSPs develop the capability to address complex issues and problems, such as health care delivery, poverty, human rights, watershed management, education, sustainability, and innovation. This book provides a comprehensive understanding of MSPs, why they are needed, the challenges partners face in working together, and how to design them effectively. Through the process of collaboration partners combine their differing strengths, vantage points, and expertise to craft innovative responses to pressing societal concerns. The book offers valuable advice for leaders about how to design and scale up effective partnerships and how to address potential obstacles partners may face, such as dealing with the conflicts and power issues likely to arise as partners negotiate with each other. Drawing on three comprehensive cases and countless shorter examples from around the world, the book offers practical advice for organizations embarking on an MSP, as well as theoretical understanding of how partnerships function. Using an institutional theory lens, it explains how partnerships can effect change in institutional fields by reducing turbulence and negotiating a common set of norms and routines to govern partners’ future interactions within the field of concern. Topics covered include: the nature of working collaboratively, why partnerships are needed, types of partnerships, guidelines for partnership design, partnerships and field dynamics, how to deal with conflicts among partners, negotiating across power differences, partnerships for sustainability, collaborative governance, working across scale differences, and how partnerships transform fields.

scholarly journals An expandable approach for design and personalization of digital, just-in-time adaptive interventions

2018 ◽  
Vol 26 (3) ◽  
pp. 198-210 ◽  
Author(s):  
Suat Gonul ◽  
Tuncay Namli ◽  
Sasja Huisman ◽  
Gokce Banu Laleci Erturkmen ◽  
Ismail Hakki Toroslu ◽  
...  
Keyword(s):  
Real Life ◽  
Personal Data ◽  
Just In Time ◽  
Intervention Design ◽  
Intervention Delivery ◽  
Life Conditions ◽  
Triggering Conditions ◽  
Delivery Strategies ◽  
Design Mechanism ◽  
Personalized Intervention

AbstractObjectiveWe aim to deliver a framework with 2 main objectives: 1) facilitating the design of theory-driven, adaptive, digital interventions addressing chronic illnesses or health problems and 2) producing personalized intervention delivery strategies to support self-management by optimizing various intervention components tailored to people’s individual needs, momentary contexts, and psychosocial variables.Materials and MethodsWe propose a template-based digital intervention design mechanism enabling the configuration of evidence-based, just-in-time, adaptive intervention components. The design mechanism incorporates a rule definition language enabling experts to specify triggering conditions for interventions based on momentary and historical contextual/personal data. The framework continuously monitors and processes personal data space and evaluates intervention-triggering conditions. We benefit from reinforcement learning methods to develop personalized intervention delivery strategies with respect to timing, frequency, and type (content) of interventions. To validate the personalization algorithm, we lay out a simulation testbed with 2 personas, differing in their various simulated real-life conditions.ResultsWe evaluate the design mechanism by presenting example intervention definitions based on behavior change taxonomies and clinical guidelines. Furthermore, we provide intervention definitions for a real-world care program targeting diabetes patients. Finally, we validate the personalized delivery mechanism through a set of hypotheses, asserting certain ways of adaptation in the delivery strategy, according to the differences in simulation related to personal preferences, traits, and lifestyle patterns.ConclusionWhile the design mechanism is sufficiently expandable to meet the theoretical and clinical intervention design requirements, the personalization algorithm is capable of adapting intervention delivery strategies for simulated real-life conditions.

scholarly journals Extending Multilevel Statistical Entropy Analysis towards Plastic Recyclability Prediction

2021 ◽  
Vol 13 (6) ◽  
pp. 3553
Author(s):  
Philippe Nimmegeers ◽  
Alexej Parchomenko ◽  
Paul De Meulenaere ◽  
Dagmar R. D’hooge ◽  
Paul H. M. Van Steenberge ◽  
...  
Keyword(s):  
Circular Economy ◽  
Real Life ◽  
Plastic Waste ◽  
Entropy Analysis ◽  
Waste Collection ◽  
Statistical Entropy ◽  
Waste Streams ◽  
Material Component ◽  
Future Work

Multilevel statistical entropy analysis (SEA) is a method that has been recently proposed to evaluate circular economy strategies on the material, component and product levels to identify critical stages of resource and functionality losses. However, the comparison of technological alternatives may be difficult, and equal entropies do not necessarily correspond with equal recyclability. A coupling with energy consumption aspects is strongly recommended but largely lacking. The aim of this paper is to improve the multilevel SEA method to reliably assess the recyclability of plastics. Therefore, the multilevel SEA method is first applied to a conceptual case study of a fictitious bag filled with plastics, and the possibilities and limitations of the method are highlighted. Subsequently, it is proposed to extend the method with the computation of the relative decomposition energies of components and products. Finally, two recyclability metrics are proposed. A plastic waste collection bag filled with plastic bottles is used as a case study to illustrate the potential of the developed extended multilevel SEA method. The proposed extension allows us to estimate the recyclability of plastics. In future work, this method will be refined and other potential extensions will be studied together with applications to real-life plastic products and plastic waste streams.

scholarly journals Evaluating Mechanisms: Mapping Weekly Dynamics between Experiential Avoidance and SAD Symptoms

2021 ◽  
Author(s):  
Laurel D. Sarfan ◽  
Joshua C. Magee ◽  
Elise M. Clerkin
Keyword(s):  
Experiential Avoidance ◽  
Change Score ◽  
Avoidance Task ◽  
Symptom Change ◽  
Empirically Supported ◽  
Task Training ◽  
Clinical Questions ◽  
Pilot Intervention ◽  
Future Work

AbstractWidely-used, empirically-supported treatments focus on reducing experiential avoidance (EA) as a mechanism of social anxiety disorder (SAD) symptom change. However, little is known about how EA and SAD symptoms bidirectionally interrelate from session to session, or throughout the course of an intervention—a gap that raises significant theoretical and clinical questions about the mechanistic role of EA. Participants (N = 78) with elevated EA and SAD symptoms completed a 3-session pilot intervention (Approach-Avoidance Task training plus psychoeducation) designed to target EA. Bivariate latent change score modeling was then used to map the bidirectional, temporal interrelationships between EA and SAD symptoms from session to session. Analyses accounted for the overall trajectory of change in both variables (i.e., EA and SAD) and both variables’ preceding measurement. Findings suggested that changes in SAD symptoms preceded and predicted changes in EA from session to session. Contrary to hypotheses, this effect was not bidirectional, as changes in EA did not precede and predict changes in SAD symptoms from session to session. The use of a relatively small analogue sample limit the external validity of the present findings. Nevertheless, these novel findings advance our understanding of the dynamic interrelationships between EA and SAD symptoms throughout treatment. Moreover, given that many leading treatments target EA, this study highlights a need for future work to continue evaluating whether EA is indeed a mechanism of SAD symptom change.

Sacubitril/valsartan in real-life European patients with heart failure with reduced ejection fraction: a systematic review and meta-analysis

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
S Giovinazzo ◽  
L Carmisciano ◽  
M Toma ◽  
M.P Sormani ◽  
M Canepa ◽  
...  
Keyword(s):  
Meta Analysis ◽  
Nyha Class ◽  
Real Life ◽  
Original Research ◽  
Baseline Characteristic ◽  
Class Iii ◽  
Real World Data ◽  
Full Dose ◽  
Reduced Ejection Fraction ◽  
Inverse Variance

Abstract Background Real-world data are needed to gauge how a therapy is implemented in clinical practice. Methods We systematically reviewed the abstracts presented at international congresses and the peer-reviewed original research articles, which described the use of sacubitril/valsartan in European patients with HFrEF from Sep 2014 until Nov 30, 2019. Meta-analysis estimates were combined using a random effects model with inverse variance weights. Results 15 abstracts and 11 articles, including 14,179 patients, were selected. Except for a study that evaluated 12,082 (85,2%) subjects, the sample size was 28 (0.2%) to 1,120 (7.9%) patients. Taking as reference PARADIGM-HF, few baseline characteristic were reported for >80% of the pooled population (Table), while all other ones were available for 12% of subjects or less (Figure). Underreporting was less common for articles than for abstracts (OR 0.42, 95% CI: 0.20–0.91). Compared with the patients enrolled in PARADIGM-HF, those in real-life were older and more likely to being previously treated with ARB, MRA and diuretics (Table). NYHA class III-IV (OR 2.39, 95% CI: 1.58–3.59; I2=92%), ICD (OR 4.21, 95% CI: 2.31–7.69; I2=93%) and CRT (OR 4.53, 95% CI: 3.89–5.27; I2=0%) were also more likely, while a history of hypertension was less frequent (OR 0.61, 95% CI: 0.42–0.87; I2=82%). The monthly achievement rate of the full dose of sacubitril/valsartan was 6%. When follow-up was ≥6 months, the percentage of subjects reaching the full dose was about 40% and very homogenous. Age and full dose attainment were inversely related (β −2.71, 95% CI: −5.3 to −0.1). All cause-mortality and hospitalization rates were 6/100 person-year (9 studies, 1046 patients) and 25/100 person-year (5 studies, 775 patients), respectively. Conclusions With the limitation of being heterogeneous and of overall low quality, the literature suggests that, in Europe, sacubitril/valsartan is prescribed to patients with somehow more severe HFrEF than in the pivotal trial, who most often do not reach the full dose. Funding Acknowledgement Type of funding source: None

Effectiveness of Digital Health Interventions on Unintentional Injury, Violence, and Suicide: Meta-Analysis

2020 ◽  
pp. 152483802096734
Author(s):  
Mengtong Chen ◽  
Ko Ling Chan
Keyword(s):  
Interpersonal Violence ◽  
Care Delivery ◽  
Digital Health ◽  
Meta Analysis ◽  
Random Effect ◽  
Unintentional Injury ◽  
Health Interventions ◽  
Effect Sizes ◽  
Future Research ◽  
Face To Face

Digital technologies are increasingly used in health-care delivery and are being introduced into work to prevent unintentional injury, violence, and suicide to reduce mortality. To understand the potential of digital health interventions (DHIs) to prevent and reduce these problems, we conduct a meta-analysis and provide an overview of their effectiveness and characteristics related to the effects. We searched electronic databases and reference lists of relevant reviews to identify randomized controlled trials (RCTs) published in or before March 2020 evaluating DHIs on injury, violence, or suicide reduction. Based on the 34 RCT studies included in the meta-analysis, the overall random effect size was 0.21, and the effect sizes for reducing suicidal ideation, interpersonal violence, and unintentional injury were 0.17, 0.24, and 0.31, respectively, which can be regarded as comparable to the effect sizes of traditional face-to-face interventions. However, there was considerable heterogeneity between the studies. In conclusion, DHIs have great potential to reduce unintentional injury, violence, and suicide. Future research should explore DHIs’ successful components to facilitate future implementation and wider access.

scholarly journals Abiraterone in chemotherapy-naive patients with metastatic castration-resistant prostate cancer: a systematic review of ‘real-life’ studies

2018 ◽  
Vol 10 (10) ◽  
pp. 305-315 ◽  
Author(s):  
Michele Marchioni ◽  
Petros Sountoulides ◽  
Maida Bada ◽  
Sebastiano Rapisarda ◽  
Cosimo De Nunzio ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Adverse Events ◽  
Meta Analysis ◽  
Real Life ◽  
Castration Resistant Prostate Cancer ◽  
The Real ◽  
Castration Resistant ◽  
Real Life Setting ◽  
Grade 3 ◽  
Baseline Psa

Background: To assess the efficacy and safety of treatment with abiraterone acetate (AA) in chemotherapy-naïve men with metastatic castration-resistant prostate cancer (mCRPC) in the ‘real-life’ setting. Methods: Data acquisition on the outcomes of the use of AA in chemotherapy-naive patients with mCRPC was performed by a MEDLINE comprehensive systematic literature search using combinations of the following key words: ‘prostate cancer’, ‘metastatic’, ‘castration resistant’, ‘abiraterone’, ‘real life’, and excluding controlled clinical trials (phase II and III studies). Identification and selection of the studies was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) criteria. Outcomes of interest were overall survival (OS), progression-free survival (PFS), 12-week 50% reduction in prostate-specific antigen (PSA), and grade 3 and higher adverse events. Data were narratively synthesized in light of methodological and clinical heterogeneity. Results: Within the eight identified studies that fulfilled the criteria, a total of 801 patients were included in the meta-analysis. Baseline PSA ranged between 9.5 and 212.0 ng/ml. Most of the patients had bone metastases. Duration of treatment with AA was longer in the studies with lower baseline PSA levels. The median OS ranged between 14 and 36.4 months. The PFS, assessed according to different definitions, ranged from 3.9 to 18.5 months. A 50% PSA reduction at 12 weeks was reached by a variable percentage of patients ranging from 36.0% to 62.1%. Finally, the rate of grade 3 and higher adverse events was reported in three studies and ranged from 4.4% to 15.5%. Conclusions: Despite the high grade of heterogeneity among studies, treatment with AA seems to ensure good survival outcomes in the ‘real-life’ setting. However, prospective studies based on patients’ characteristics being more similar to ‘real-life’ patients are necessary.

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