Digital mHealth and Virtual Care Monitoring and Support in Pandemics: Part 2 - A Rapid Review Assessing Strategies during COVID-19 (Preprint)

2021 ◽  
Author(s):  
Alessandro Cau ◽  
Alison Müller ◽  
Samia El Joueidi ◽  
Ka Hong Chan ◽  
Jay JH Park ◽  
...  
Keyword(s):  
Health Care ◽  
Clinical Trials ◽  
Mobile Phone ◽  
Chronic Diseases ◽  
Systematic Reviews ◽  
Health Care Professionals ◽  
Randomized Clinical Trials ◽  
Contact Tracing ◽  
Rapid Review ◽  
Virtual Care

BACKGROUND As a result of the novel coronavirus 2019 (COVID-19) pandemic, fewer patients are able to communicate with their health care professionals due to widely encouraged physical distancing. This provides a unique opportunity to evaluate and test the effectiveness of virtual care globally, especially mobile phone facilitated health interventions, called mHealth. This review evaluates how this rapidly growing field of virtual care could be effective in a pandemic situation by using mHealth interventions to manage chronic diseases, in addition to filling gaps within the health care system that have arisen due to COVID-19. OBJECTIVE To synthesize the published information regarding mobile phone-based virtual care technologies for mHealth interventions implemented in previous pandemics and chronic care. This information can provide an evidence-base to the patient experience and public health virtual care approaches toward COVID-19 control and health services beyond the pandemic. METHODS For this rapid review, we included systematic reviews (restricted within the past 2 years), randomized control trials, controlled non-randomized clinical trials, prospective and retrospective cohort studies, and case control studies reporting on mHealth and telehealth technologies on chronic, non-communicable diseases and infectious disease outbreaks and patient centered clinical decision support tools (symptom checkers, chatbots, digital self-triage technologies). PubMed and Cochrane Systematic Libraries were searched for studies dated between 1973 (when the first mobile phone was invented) and August 10, 2020. AMSTAR2 was used to evaluate the quality of systematic reviews. RESULTS Of 4083 potentially relevant records, 130 meeting our inclusion criteria for this review. For virtual care and mHealth technologies managing patient care, the general consensus among systematic reviews was that there is mixed evidence evaluating its efficacy in improving overall health outcomes. Clinical trials assessing adherence to chronic diseases management strategies were the most promising. The inconsistency observed regarding the efficacy of mHealth and virtual care interventions stems from research study bias, dependence on self-reporting, small samples sizes, among many other factors. This noted inconsistency extended to mHealth and virtual care interventions used during pandemics, predominantly focusing on HIV. There have been no evaluations investigating the effectiveness of digitalized case contact tracing during a pandemic or support for isolated individuals and/or health care workers. CONCLUSIONS Virtual care technologies could be effective in communicating crucial health care support and advice to patients managing chronic and infectious diseases, as well as individuals in self-isolation. There is no direct evidence regarding the use of virtual care technologies during a respiratory disease-based pandemic; however, reviewing available literature can provide insights into effective virtual care interventions for implementation during a pandemic such as COVID-19. CLINICALTRIAL N/A

scholarly journals How Safe is the use of Antiseptics and Disinfectants in Children?

2021 ◽  
Vol 5 (3) ◽  
pp. RV6-RV9
Author(s):  
Abdullah Hosseni ◽  
Nirmal Thapa ◽  
Priya T.
Keyword(s):  
Health Care ◽  
Clinical Trials ◽  
Health Care Professionals ◽  
Healthcare Professionals ◽  
Pediatric Patients ◽  
Randomized Clinical Trials ◽  
Research Work ◽  
Toxic Effects ◽  
Safety And Efficacy ◽  
Wide Range

A wide range of antiseptic preparations and disinfectants have been used in varying concentrations and combinations in children but much research work regarding their safety and efficacy is not available. The aim of this review is to expand and broaden the pre-existing guidelines useful to the health care professionals so that antisepsis in the pediatric field can be performed appropriately, and at the same time, guarantee safety for children. Previously published studies were also assessed while writing this review. As per the data, there may be several local and systemic toxic effects related to the use of antiseptics and disinfectants in children. Properly designed large multicenter randomized clinical trials are required to direct the healthcare professionals regarding the most appropriate and safe antiseptic and disinfectant to use in pediatric patients.

Liraglutide for the Treatment of Obesity: Analyzing Published Reviews

2019 ◽  
Vol 25 (15) ◽  
pp. 1783-1790 ◽  
Author(s):  
Rosario Pastor ◽  
Josep A. Tur
Keyword(s):  
Weight Loss ◽  
Clinical Trials ◽  
Systematic Reviews ◽  
Randomized Clinical Trials ◽  
Statistical Tests ◽  
Overweight And Obesity ◽  
Cochrane Library ◽  
Medical Subject Headings ◽  
Mesh Terms ◽  
Treatment Of Obesity

Background: Several drugs have been currently approved for the treatment of obesity. The pharmacokinetic of liraglutide, as well as the treatment of type 2 diabetes mellitus, have been widely described. Objective: To analyze the published systematic reviews on the use of liraglutide for the treatment of obesity. Methods: Systematic reviews were found out through MEDLINE searches, through EBSCO host and the Cochrane Library based on the following terms: "liraglutide" as major term and using the following Medical Subject Headings (MesH) terms: "obesity", "overweight", "weight loss". A total of 3 systematic reviews were finally included to be analyzed. Results: From the three systematic reviews selected, only two included the randomized clinical trials, while the third study reviewed both randomized and non-randomized clinical trials. Only one review performed statistical tests of heterogeneity and a meta-analysis, combining the results of individual studies. Another review showed the results of individual studies with odds ratio and confidence interval, but a second one just showed the means and confidence intervals. In all studies, weight loss was registered in persons treated with liraglutide in a dose dependent form, reaching a plateau at 3.0 mg dose, which was reached just in men. Most usual adverse events were gastrointestinal. Conclusion: More powerful and prospective studies are needed to assess all aspects related to liraglutide in the overweight and obesity treatment.

scholarly journals A Roadmap to Inform Development, Validation and Approval of Digital Mobility Outcomes: The Mobilise-D Approach

2020 ◽  
Vol 4 (1) ◽  
pp. 13-27 ◽  
Author(s):  
Lynn Rochester ◽  
Claudia Mazzà ◽  
Arne Mueller ◽  
Brian Caulfield ◽  
Marie McCarthy ◽  
...  
Keyword(s):  
Health Care ◽  
Clinical Trials ◽  
Health Care Professionals ◽  
Digital Health ◽  
Disease Status ◽  
Proximal Femoral Fracture ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Physical Mobility ◽  
High Level

Health care has had to adapt rapidly to COVID-19, and this in turn has highlighted a pressing need for tools to facilitate remote visits and monitoring. Digital health technology, including body-worn devices, offers a solution using digital outcomes to measure and monitor disease status and provide outcomes meaningful to both patients and health care professionals. Remote monitoring of physical mobility is a prime example, because mobility is among the most advanced modalities that can be assessed digitally and remotely. Loss of mobility is also an important feature of many health conditions, providing a read-out of health as well as a target for intervention. Real-world, continuous digital measures of mobility (digital mobility outcomes or DMOs) provide an opportunity for novel insights into health care conditions complementing existing mobility measures. Accepted and approved DMOs are not yet widely available. The need for large collaborative efforts to tackle the critical steps to adoption is widely recognised. Mobilise-D is an example. It is a multidisciplinary consortium of 34 institutions from academia and industry funded through the European Innovative Medicines Initiative 2 Joint Undertaking. Members of Mobilise-D are collaborating to address the critical steps for DMOs to be adopted in clinical trials and ultimately health care. To achieve this, the consortium has developed a roadmap to inform the development, validation and approval of DMOs in Parkinson’s disease, multiple sclerosis, chronic obstructive pulmonary disease and recovery from proximal femoral fracture. Here we aim to describe the proposed approach and provide a high-level view of the ongoing and planned work of the Mobilise-D consortium. Ultimately, Mobilise-D aims to stimulate widespread adoption of DMOs through the provision of device agnostic software, standards and robust validation in order to bring digital outcomes from concept to use in clinical trials and health care.

scholarly journals Approach to the most prevalent oral disorders among the elderly: an integrative review focusing on primary health care

2017 ◽  
Vol 20 (3) ◽  
pp. 430-440
Author(s):  
Helena Pereira Rodrigues da Silva ◽  
Bárbara Koppe ◽  
Myrian Câmara Brew ◽  
Giordano Santana Sória ◽  
Caren Serra Bavaresco
Keyword(s):  
Health Care ◽  
Clinical Trials ◽  
Primary Health Care ◽  
Randomized Clinical Trials ◽  
Oral Candidiasis ◽  
The Elderly ◽  
Integrative Review ◽  
Root Caries ◽  
Geriatric Dentistry ◽  
Primary Health

Abstract Objective: an integrative review of the treatment of oral candidiasis, root caries and xerostomia among the elderly population, focusing on Primary Health Care, was carried out. Method: scientific articles were collected from the MEDLINE/PUBMED database using the keywords "Geriatric dentistry" and "Oral health", crossed with corresponding descriptors, together with specific terms for the pathologies studied, and with “the clinical trial” filter activated. The abstracts of the articles were read by three researchers. Result: oral candidiasis: six randomized clinical trials and one quasi-experimental design study, on the treatment of prosthetic stomatitis by medication and/or the disinfection of dentures by different techniques, were identified; root caries: three randomized clinical trials were included, which tested the use of mouthwash with chlorhexidine solution and oral hygiene instruction associated or otherwise with other drugs; and xerostomia: two articles were analyzed using various medications, and the functional massage of the salivary glands and associated muscles. Conclusion: The results demonstrate a variety of treatment options for the studied clinical situations, although these should be adapted to the characteristics of the services and the population, as standard treatment in Primary Health Care has not been established. Strategies based on soft technologies, such as health education, seem to provide good results. The present study provides additional knowledge for health professionals in search of more resolutive and qualified dental care for the elderly in primary health care.

scholarly journals Publication Trends in Rheumatology Systematic Reviews and Randomized Clinical Trials, 1995–2017

2020 ◽  
pp. jrheum.200593
Author(s):  
Michael S. Putman ◽  
Alexander Chaitoff ◽  
Joshua D. Niforatos
Keyword(s):  
Clinical Trials ◽  
Systematic Reviews ◽  
Randomized Clinical Trials ◽  
Publication Trends ◽  
Academic Pressure ◽  
Technological Advances

The growth of systematic reviews and metaanalyses (SRMA) has outpaced the growth of randomized clinical trials (RCT) in many medicine subspecialties1. This may reflect technological advances in SRMA production, fewer barriers to publish, or academic pressure to produce citations2.

scholarly journals The culture of hope and ethical challenges in clinical trials: A qualitative study of oncologists and haematologists’ views

2019 ◽  
Vol 15 (1) ◽  
pp. 29-38 ◽  
Author(s):  
Tove E Godskesen ◽  
Suzanne Petri ◽  
Stefan Eriksson ◽  
Arja Halkoaho ◽  
Margrete Mangset ◽  
...  
Keyword(s):  
Health Care ◽  
Clinical Trials ◽  
Qualitative Study ◽  
Empirical Research ◽  
Health Care Professionals ◽  
Therapeutic Misconception ◽  
Ethical Challenges ◽  
Know How ◽  
Ethical Concerns ◽  
Clinical Cancer

We do not know how much clinical physicians carrying out clinical trials in oncology and haematology struggle with ethical concerns. To our knowledge, no empirical research exists on these questions in a Nordic context. Therefore, this study aims to learn what kinds of ethical challenges physicians in Sweden, Denmark and Finland (n = 29) face when caring for patients in clinical trials; and what strategies, if any, they have developed to deal with them. The main findings were that clinical cancer trials pose ethical challenges related to autonomy issues, unreasonable hope for benefits and the therapeutic misconception. Nevertheless, some physicians expressed that struggling with such challenges was not of great concern. This conveys a culture of hope where health care professionals and patients uphold hope and mutually support belief in clinical trials. This culture being implicit, physicians need opportunities to deliberately reflect over the characteristics that should constitute this culture.

On the Evaluation of Treatments for Narcotics Addiction

1979 ◽  
Vol 9 (2) ◽  
pp. 205-211 ◽  
Author(s):  
Vincent P. Dole ◽  
Burton Singer
Keyword(s):  
Clinical Trials ◽  
Randomized Trial ◽  
Observational Data ◽  
Chronic Diseases ◽  
Drug Addiction ◽  
Randomized Trials ◽  
Randomized Clinical Trials ◽  
The Other ◽  
Domain Of Applicability

This study is concerned with the domain of applicability of randomized clinical trials. For evaluation of well-defined treatments of acute diseases over limited periods of time, the randomized trial technique is unquestionably the best. However, in the field of chronic diseases (as illustrated by drug addiction) the physician's responsibility extends over periods of years, and his judgements involve consideration of many contingent factors which vary in the course of the disease. In this domain, randomized clinical trials, however ambitious in design, give only partial guidance. Observational data therefore must be used if treatment is to be optimized for individual patients. Two randomized trials in the treatment of narcotics addiction — one testing methadone and the other naltrexone — are reviewed, with comments on their conclusions and limitations.

scholarly journals Case-Initiated COVID-19 Contact Tracing Using Anonymous Notifications (Preprint)

2020 ◽  
Author(s):  
Weibin Cheng ◽  
Chun Hao
Keyword(s):  
Health Care ◽  
Mobile Phone ◽  
Access To Health Care ◽  
Advanced Technology ◽  
Care Staff ◽  
Contact Tracing ◽  
Health Care Staff ◽  
Disease Information ◽  
Access To Health ◽  
Respiratory Hygiene

UNSTRUCTURED We discuss the concept of a participatory digital contact notification approach to assist tracing of contacts who are exposed to confirmed cases of coronavirus disease (COVID-19); the approach is simple and affordable for countries with limited access to health care resources and advanced technology. The proposed tool serves as a supplemental contract tracing approach to counteract the shortage of health care staff while providing privacy protection for both cases and contacts. This tool can be deployed on the internet or as a plugin for a smartphone app. Confirmed cases with COVID-19 can use this tool to provide contact information (either email addresses or mobile phone numbers) of close contacts. The system will then automatically send a message to the contacts informing them of their contact status, what this status means, the actions that should follow (eg, self-quarantine, respiratory hygiene/cough etiquette), and advice for receiving early care if they develop symptoms. The name of the sender of the notification message by email or mobile phone can be anonymous or not. The message received by the contact contains no disease information but contains a security code for the contact to log on the platform to retrieve the information.

scholarly journals Evaluasi Persepsi Pengguna dalam Penerapan Sistem Informasi Ketersediaan Ruang Rawat dan Ketersediaan Darah di Rumah Sakit

2017 ◽  
Vol 10 (2) ◽  
Author(s):  
I Irnawati ◽  
Mokhamad Arifin ◽  
Halim Indra Kusuma
Keyword(s):  
Health Care ◽  
Information System ◽  
Mobile Phone ◽  
Personal Computer ◽  
Health Care Professionals ◽  
Cross Sectional ◽  
Purposive Sampling ◽  
Examination Result ◽  
Health Community ◽  
Integrated Information System

Petugas kesehatan sering mengalami kesulitan dalam mencari rumah sakit rujukan dan kantong darah untuk transfusi karena belum tersedianya sistem informasi ruang rawat di rumah sakit dan informasi stok darah PMI yang terintegrasi dan mudah diakses dengan “one click”. Adanya solusi dengan aplikasi siDarurat yang merupakan sistem informasi ketersediaan ruang rawat dan ketersediaan darah berbasis website yang dapat diakses melalui personal computer, handphone, dan android. Tujuan penelitian untuk mengevaluasi persepsi pengguna dalam penerapan sistem informasi ketersediaan ruang rawat dan ketersediaan darah di rumah sakit kabupaten pekalongan. Metode Penelitian ini merupakan penelitian kuantitatif deskriptif sederhana dengan rancangan penelitian  cross sectional. Sampel yang digunakan sebanyak 42 responden dengan cara purposive sampling yang merupakan dokter, perawat, bidan, analis baik dirumah sakit maupun puskesmas serta masyarakat. Uji statistik yang digunakan adalah analisis univariat dengan distribusi frekuensi. Hasil sebagian besar 84% responden menyatakan tampilan atau user interface dari website sidarurat.com sangat bagus dan penggunaan bahasa mudah difahami, 86% responden menyatakan informasi tentang kesediaan ruang rawat dan ketersediaan darah dibutuhkan sehari-hari serta mudah diakses dari handphone atau tablet, 80% responden menyatakan data yang tersaji dalam website sidarurat.com akurat dan sesuai dengan harapan. Simpulan berdasarkan persepsi pengguna website sidarurat.com tampilan sangat bagus, bahasanya mudah difahami, informasinya dibutuhkan sehari-hari, mudah diakses dari handphone dan tablet, serta akurat dan sesuai dengan harapan. Kata Kunci : evaluation of information system, sidarurat, user  perseption Evaluation of The Perception of The User in The Application of Information Systems and Rooming Space Availability Availability of Blood in Hospitals Background: health care professionals often experience in finding reffereal hospital and blood for transfusion due to unavailibility of integrated information system at the ward in the hospital and information of blood stock at Indonesian blood bank  which is easily to access with one click. SiDarurat application is an information system of the availibility of bed in the ward and blood with the websites based which can be access through personal computer, handphone, and android. Purpose: to evaluate the perception of the user in the implementation of bed and blood availibility information system at the hospital in pekalongan region. Method: this study is quantitative study, simple descriptive with cross sectional approach. 42 respondents purposive sampling were included in this study involving doctors, nurses, midwifes and laboratoriun technicians of the hospitals and publich health community. Univariat analysis with fequency distribution was occupied for statistical examination. Result: 84% of the respondents explain that the performance or interface user of the website of SiDarurat.com was very good and the language was easy to understand, 86% of the respondents said that the information of the bed and blood availibility is needed daily and easy to access from mobile phone and tablet, 80% of the respondents explained the data provided in the sidarurat website was accurate and as what their expected. Conclusion: based on the perception of the sidarurat website users, the sidarurat websites had a very good performance, the language was easily to understand, the information is needed daily and easy to access through mobile phone and tablet and accurate and the content as what users expected. Kata Kunci : evaluation of information system, sidarurat, user  perseption

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