scholarly journals Telemedicine in Malignant and Nonmalignant Hematology: Systematic Review of Pediatric and Adult Studies (Preprint)

2021 ◽  
Author(s):  
Aashaka C Shah ◽  
Linda C O’Dwyer ◽  
Sherif M Badawy

BACKGROUND Telemedicine, including video-, web-, and telephone-based interventions, is used in adult and pediatric populations to deliver health care and communicate with patients. In the realm of hematology, telemedicine has recently been used to safely and efficiently monitor treatment side-effects, perform consultations, and broaden the reach of subspecialty care. OBJECTIVE We aimed to synthesize and analyze information regarding the feasibility, acceptability, and potential benefits of telemedicine interventions in malignant and nonmalignant hematology, as well as assess the recognized limitations of these interventions. METHODS Studies were identified through a comprehensive Medical Subject Headings (MeSH) search on the PubMed MEDLINE, Controlled Register of Clinical Trials (Cochrane CENTRAL from Wiley), Embase, and CINAHL (EBSCO) databases on February 7, 2018. A second search, utilizing the same search strategy, was performed on October 1, 2020. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines in the reporting of included evidence. Included studies were original articles researching the feasibility, acceptability, and clinical outcomes of telemedicine or telehealth interventions in pediatric or adult populations with malignant or nonmalignant hematological conditions. Data items in the extraction form included first author name, publication year, country, malignant or nonmalignant hematological condition or disease focus of the study, participant age, participant age subgroup (pediatric or adult), study design and setting, telemedicine intervention type and description, study purpose, and main study outcomes. RESULTS A total of 32 articles met the preset criteria and were included in this study. Most (25/32) studies were conducted in adults, and the remaining (7/32) were conducted in the pediatric population. Of the 32 studies, 12 studied malignant hematological conditions, 18 studied nonmalignant conditions, and two studied both malignant and nonmalignant conditions. Study types included pilot study (11/32), retrospective study (9/32), randomized controlled trial (6/32), cross-sectional study (2/32), case study (1/32), pre-post study (1/32), noncomparative prospective study (1/32), and prospective cohort study (1/32). The three main types of telemedicine interventions utilized across all studies were video-based (9/32), telephone-based (9/32), and web-based interventions (14/32). Study results showed comparable outcomes between telemedicine and traditional patient encounter groups across both pediatric and adult populations for malignant and nonmalignant hematological conditions. CONCLUSIONS Evidence from this review suggests that telemedicine use in nonmalignant and malignant hematology provides similar or improved health care compared to face-to-face encounters in both pediatric and adult populations. Telemedicine interventions utilized in the included studies were well received in both pediatric and adult settings. However, more research is needed to determine the efficacy of implementing more widespread use of telemedicine for hematological conditions.

10.2196/29619 ◽  
2021 ◽  
Vol 9 (7) ◽  
pp. e29619
Author(s):  
Aashaka C Shah ◽  
Linda C O’Dwyer ◽  
Sherif M Badawy

Background Telemedicine, including video-, web-, and telephone-based interventions, is used in adult and pediatric populations to deliver health care and communicate with patients. In the realm of hematology, telemedicine has recently been used to safely and efficiently monitor treatment side-effects, perform consultations, and broaden the reach of subspecialty care. Objective We aimed to synthesize and analyze information regarding the feasibility, acceptability, and potential benefits of telemedicine interventions in malignant and nonmalignant hematology, as well as assess the recognized limitations of these interventions. Methods Studies were identified through a comprehensive Medical Subject Headings (MeSH) search on the PubMed MEDLINE, Controlled Register of Clinical Trials (Cochrane CENTRAL from Wiley), Embase, and CINAHL (EBSCO) databases on February 7, 2018. A second search, utilizing the same search strategy, was performed on October 1, 2020. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines in the reporting of included evidence. Included studies were original articles researching the feasibility, acceptability, and clinical outcomes of telemedicine or telehealth interventions in pediatric or adult populations with malignant or nonmalignant hematological conditions. Data items in the extraction form included first author name, publication year, country, malignant or nonmalignant hematological condition or disease focus of the study, participant age, participant age subgroup (pediatric or adult), study design and setting, telemedicine intervention type and description, study purpose, and main study outcomes. Results A total of 32 articles met the preset criteria and were included in this study. Most (25/32) studies were conducted in adults, and the remaining (7/32) were conducted in the pediatric population. Of the 32 studies, 12 studied malignant hematological conditions, 18 studied nonmalignant conditions, and two studied both malignant and nonmalignant conditions. Study types included pilot study (11/32), retrospective study (9/32), randomized controlled trial (6/32), cross-sectional study (2/32), case study (1/32), pre-post study (1/32), noncomparative prospective study (1/32), and prospective cohort study (1/32). The three main types of telemedicine interventions utilized across all studies were video-based (9/32), telephone-based (9/32), and web-based interventions (14/32). Study results showed comparable outcomes between telemedicine and traditional patient encounter groups across both pediatric and adult populations for malignant and nonmalignant hematological conditions. Conclusions Evidence from this review suggests that telemedicine use in nonmalignant and malignant hematology provides similar or improved health care compared to face-to-face encounters in both pediatric and adult populations. Telemedicine interventions utilized in the included studies were well received in both pediatric and adult settings. However, more research is needed to determine the efficacy of implementing more widespread use of telemedicine for hematological conditions.


Avicenna ◽  
2021 ◽  
Vol 2022 (1) ◽  
Author(s):  
Yaman M. AlAhmad ◽  
Duaa Mahmoud Haggeer ◽  
Abrar Yaser Alsayed ◽  
Mahmoud Y. Haik ◽  
Leen Maen AbuAfifeh ◽  
...  

Introduction: Telemedicine is the delivery of health care services to patients distantly. During the Coronavirus Disease 2019 (COVID-19) pandemic, telemedicine has become an essential implement in delivering healthcare services worldwide. Accordingly, in March 2020, the Primary Health Care Centers (PHCCs) in Qatar has started telephone consultation follow-up appointments in Family Medicine (FM) clinics instead of conventional consultation. Given the limited data about telephone consultations in Qatar, our aim of this study is to investigate the possible impact of telemedicine on chronic disease patients’ follow-up compliance. Methods: This study compares the compliance of adult patients with chronic diseases following-up within FM clinics in Qatar's PHCC through telephone consultations with a minimum of three telephone consultations ordered between April to November 2020, in comparison to the compliance of the same group of patients to their prior face-to-face follow-up consultations in FM clinics with a minimum of three face-to-face ordered follow up appointments between April to November 2019. A cross-sectional study will be carried out to investigate the effect of telephone consultation in PHCC on patients’ compliance with reference to conventional face-to-face consultation. Patients’ data will be received from Health Information Management in twenty-seven PHCCs in Qatar. Conclusion: Due to the limited studies on the effectiveness of telemedicine on patient compliance in FM follow-ups within Qatar's PHCC, comparing patients’ follow-up compliance with telephone consultations to their prior face-to-face consultations would be helpful in assessing patients’ quality of care delivering within FM clinics. With telecommunication being easily accessible and time-efficient, it is believed, when used correctly, it might improve compliance and adherence to the management prescribed by the physician and follow-up appointments in Qatar's PHCC. In addition, this study will help in providing recommendations that could guide the organization on forming policies to be applied in PHCCs after the resolution of the COVID-19 pandemic.


2020 ◽  
Vol 26 (Supplement_1) ◽  
pp. S11-S12
Author(s):  
Cole Johnson ◽  
Edward Barnes ◽  
Xian Zhang ◽  
Millie Long

Abstract Background and Aims There are currently several recruitment challenges in randomized controlled trials (RCT) for inflammatory bowel disease (IBD) which prolong the drug approval process and affect the generalizability of study results. The purpose of this study is to characterize individuals who participate in IBD RCTs and identify factors which could influence future recruitment strategies. Methods We performed a cross-sectional study within the IBD Partners cohort comparing patients with current or prior participation in an interventional randomized controlled trial (RCT) of a medical therapy for IBD to those without any RCT participation. Bivariate statistics were used to compare RCT participation by IBD subtype and by other demographic and disease characteristics, and predictive modeling was used to identify factors predictive of RCT participation. We calculated the percent of the cohort that participated an in RCT during each calendar year from 2011–2018 and Clinicaltrials.gov was accessed to determine the number of active RCTs for IBD therapies per year during that same period. Results A total of 14,747 patients with IBD were included in the analysis and 1,116 (7.6%) reported RCT participation at any time. Demographic factors predictive of RCT participation (Table 1) included following at an academic institution (OR=1.8; 95%CI: 1.51–2.04) and age 36–75 (OR=1.6; 95%CI: 1.43–1.87). Patients with Crohn’s disease (CD) were more likely to participate than those with ulcerative colitis (UC) (OR=1.5; 95%CI: 1.35–1.77). Patients with more severe disease were more likely to participate, including those with prior IBD-related hospitalization (OR=2.6; 95%CI: 2.19–2.99), IBD-related surgery (OR=2.5; 95%CI: 2.24–2.87), biologic exposure (OR=3.2; 95%CI: 2.76–3.65), and “Poor” or worse quality of life (OR=1.7; 95%CI: 1.45–1.93). Steroid-free remission was associated with lower likelihood of RCT participation (OR=0.6; 95%CI: 0.53–0.70). While the number of active RCTs for IBD more than doubled between 2011 and 2018, RCT participation rates during that same time period decreased from 1.1% to 0.7% of the cohort (Figure 1). Conclusions RCT participation rates declined within this cohort between 2011–2018. Groups underrepresented in RCTs for IBD included younger patients, patients followed in community settings, and patients with more mild disease. The non-RCT group had mean sCDAI and SCCAI scores that did not meet remission thresholds, demonstrating populations in need of alternate therapies for whom clinical trials could be an option. Given anti-TNF exposure rates in this national cohort, studies should focus on anti-TNF failure populations. Investigators should make every effort to offer RCTs to all patients and network with community providers to increase awareness of RCTs.


2021 ◽  
Vol 3 (6) ◽  
pp. 89-94
Author(s):  
Philippe Salomon Nguwoh ◽  
Akenji Blaise Mboringong ◽  
Joseph Fokam ◽  
Christian Ngounouh Taheu ◽  
Ibrahima Halilou ◽  
...  

Introduction: Coronavirus Disease 2019 (COVID-19) caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) first appeared in December 2019 in Wuhan, China and has subsequently become a worldwide pandemic. During the pandemic, health care workers (HCWs) were very exposed to COVID-19 infected patients. The aim of this study was to determine seroprevalence of SARS-CoV-2 (COVID-19) among HCWs in three health facilities of Yaounde. Methods: A cross-sectional study involving 368 HCWs was conducted from January 18th to February 13th, 2021, in three health facilities located in city of Yaounde. Data of study participants were collected by face-to-face interviews using standard questionnaire. Blood samples were collected in labelled dry tubes and analyzed using Rapid Diagnostic Test (RDT) cassettes (Abbott PanbioTMCOVID-19 IgG/IgM Rapid Test Device). The data collected was analyzed using Epi info version 7. Any value of p <0.05 was considered statistically significant. Results: The average age was 30.25 (SD±10.43) years old, range from 21 to 72 years old. Overall, the positivity rates of IgM, IgG and IgM+IgG were 6.79% (n=25), 17.93% (n=66) and 1.09% (n=4) respectively. Multivariate analysis showed that, the rate of IgM positivity was highest in laboratory personnel (χ2= 7.99, p=0.3) and IgG (χ2= 8.50, p=0.29), IgM+IgG (χ2= 1.92, p=0.26) respectively in pharmacy and clinical personnel. The clinical signs such as fever (˃38°C) or history of fever was statistically significant with IgM (χ2=11.71, p= 0.0006) while, sore throat was statistically significant associated with IgM (χ2= 14.3, p= 0.0008) and IgG (χ2= 6.33, p= 0.04). Conclusion: The results of this study reveal a high seroprevalence of circulation of the virus in hospital milieu in Yaounde suggesting the continuation of the COVID-19 « Track-Test-Treat » system to break the chain of transmission.


Author(s):  
Bruna Rafaele Vieira PEDROSA ◽  
Walésia Laianny Leite MARTINS ◽  
Híttalo Carlos Rodrigues de ALMEIDA ◽  
Veronica Maria da Rocha KOZMHINSKY ◽  
Maria de Fátima Pessoa de Araújo SABINO ◽  
...  

ABSTRACT Objective: identifying the parents/guardians’ knowledge about the oral health condition of oncological children assisted at the Pediatric Oncology Department of the Institute of Integral Medicine Professor Fernando Figueira. Methods: A cross-sectional study comprising a sample of 163 parents/guardians of children assisted at the Pediatric Oncology Department of the IIMP in the city of Recife, Pernambuco, applying a semi-structured form, tested with 10% of the sample in a pilot study. Results: Most of the parents/guardians were female subjects (87%) and patients’ mothers (81%), between 25 and 34 years of age (44.8%), with a family income of a minimum wage (47%), educational level until elementary school (51.6%) and from the countryside of the state of Pernambuco (56%). Most of the children were male subjects (58.9%) with average age of 7.57 years, who had attended or stopped primary school (54.6%) and had been diagnosed with Acute Lymphoblastic Leukemia (57.7%) and treated with chemotherapy (92.6%). All parents considered important to have dental surgeons in the oncology department assisting the children in their oral hygiene. More than half of these parents reported knowing about how to avoid caries (63%) and, almost half of the children had never had a consultation with a dentist before (41.1%). Conclusion: Parents/guardians have information about oral health care, but they do not put it into practice.


2013 ◽  
Vol 93 (11) ◽  
pp. 1456-1466 ◽  
Author(s):  
Silvia Gianola ◽  
Monica Gasparini ◽  
Michela Agostini ◽  
Greta Castellini ◽  
Davide Corbetta ◽  
...  

Background Systematic reviews (SRs) have become increasingly important for informing clinical practice; however, little is known about the reporting characteristics and the quality of the SRs relevant to the practice of rehabilitation health professionals. Objective The purpose of this study was to examine the reporting quality of a representative sample of published SRs on rehabilitation, focusing on the descriptive, reporting, and bias-related characteristics. Methods A cross-sectional study was conducted by searching MEDLINE for aggregative and configurative SRs indexed in 2011 that focused on rehabilitation as restorative of functional limitations. Two reviewers independently screened and selected the SRs and extracted data using a 38-item data collection form derived from Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). The data were analyzed descriptively. Results Eighty-eight SRs published in 59 journals were sampled. The median compliance with the PRISMA items was 17 (63%) out of 27 items (interquartile ratio=13–22 [48%–82%]). Two thirds of the SRs (n=66) focused on interventions for which efficacy is best addressed through a randomized controlled trial (RCT) design, and almost all of these SRs included RCTs (63/66 [95%]). More than two thirds of the SRs assessed the quality of primary studies (74/88 [84%]). Twenty-eight reviews (28/88 [32%]) meta-analyzed the results for at least one outcome. One half of the SRs reported positive statistically significant findings (46%), whereas a detrimental result was present only in one review. Conclusions This sample of SRs in the rehabilitation field showed heterogeneous characteristics and a moderate quality of reporting. Poor control of potential source of bias might be improved if more widely agreed-upon evidence-based reporting guidelines will be actively endorsed and adhered to by authors and journals.


Author(s):  
Nilofur Banu ◽  
Kalaivani Annadurai ◽  
Karnaboopathy Ranganathan

Background: Health seeking behavior is an important decision in health care management and it becomes more relevant among underprivileged populations like urban slums. The objectives of the study was to find out the morbidity pattern, health care seeking behaviours , the morbidity pattern its determinants among urban slum dwellers in Chennai.Methods: This descriptive cross sectional study was conducted among 400 respondents of Nallakuppam slum in Chennai by systematic random sampling method from October 2017 to October 2019. A semi structured schedule was used to collect information among them after their valid informed consent. Descriptive statistics such as frequency and percentage were used.  Chi square test was used to assess the association between factors.Results: Almost half of the study participants (53.50%) were female and 30.50% have completed high school education. Hindu was the major religion practiced and most of them belonged to lower middle socio economic class. Though majority of the study population suffered from communicable diseases like ARI and fever which might be due to overcrowding in that area, treatment seeking behavior was found to be good among the study participant suffering from non-communicable disease like DM, HTN and CHD, which showed that the type of disease played an vital role in seeking treatment among the study participants.Conclusions: Though the study participants had different choice in health care such as government, private or some time both facilities for treating their illness, trust on the health care provider played an important role in availing services from particular health care facilities.


2016 ◽  
Vol 25 (Number 1) ◽  
pp. 29-35
Author(s):  
K S Anwar ◽  
N Haque ◽  
S Ahmed ◽  
A Nasreen

This was a description type of cross sectional study conducted among 210 rural mothers having 0-6 months child, attending the out patient department of Sirajdikhan Upazilla Heath Complex, Munshigonj. Total 210 women were selected by purposive sampling method. Data were collected through structured questionnaire by face to face interview Out of 210 respondents, majority (59.52%) was in the age group 18-27 years and only 0.48% was above 47 years. Mean age of the respondents was 26.29 years. Most of the respondents (43.33%) completed SSC and only 3.8% were uneducated. Among the respondents 83.33% were house wives. Monthly incomes of the respondents (39.05%) were more than 12000 taka. Most of the mother (80.95%) had children of age 1-3 years. Majority of mothers (77.14%) had conception about requirement of initiation of weaning at 6 months and 15.24% had at 5 months. Maximum respondents (44.76%) had given khichury, 44.29% Shuji and rest of them (10.95%) had given home made food. Mothers (78.57%) continued breast feeding with weaning. About 74.76% respondents complained of occasional vomiting with weaning. Majority (62.38%) of children had given food on time, those children who were provided complementary feeding was physically normal. Majority (57.14%) of mothers had no complained during weaning period. Registered physicians (76.19%) were the health care provider when the children were sick. Although most of the mothers started weaning at appropriate times, we cannot consider it satisfactory. As we must think about all the children and keep all of them healthy, we need to improve this rate up to 100%. Unless we achieve this level we can't achieve our goals of health for all.


2021 ◽  
Vol 16 (2) ◽  
pp. 54-64
Author(s):  
Baizid Khoorshid Riaz ◽  
Sk Akhtar Ahmad ◽  
Md Ziaul Islam ◽  
Liaquat Ali

Background: Community Clinics (CC) has been established to provide basic healthcare services at the doorstep of the community people in Bangladesh. Besides health care, government has taken a development program through CC to improve maternal health care with an aim to reduce the maternal mortality. This study was an attempt to find out the role of community women in the utilization and participation of CC management. Methods: This cross-sectional study was carried out in 32 randomly selected CCs from 16 randomly selected districts. A total of 63 service providers, 2238 service users (patients) and 3285 community members were included as the respondents of this study. For data collection respondents were interviewed face to face by using a pretested questionnaire. Results: The majority of the service providers of the CC were from the local community, and a higher proportion of them were female (52.4%). The providers provided healthcare services both in CC and at community level. A total of 2238 patients visited the 32 studied CCs per day for getting treatment and significantly a higher proportion of them were female (71.2%). Most of the patients (83.0%) expressed satisfaction with the services provided in the CCs and most of them were female (83.8%). Of the total 3285 respondents, 60.3% were the women from the catchment communities. The activities of the CC were known by all of them (98.3%) and they participated in the management of CC. Conclusions: The study revealed that because of utilization and participation in the management of CC, the women became an imperative person in the community, thus empowering them in healthcare development.


2018 ◽  
Vol 20 (06) ◽  
pp. 924-928
Author(s):  
EJAZ HUSSAIN SIDDIQUI ◽  
SAAD SIDDIQUI ◽  
GHULAM RASOOL ◽  
Naseer Khan

Objectives: To assess common presenting complaints & the role of Grey Scale and Doppler ultrasound in evaluation ofscrotal pathologies. Design: Cross sectional study, Setting: Khyber X rays, Khyber Medical Centre, Peshawar. Period: July 2011 toDecember 2011. Material and Methods: Data from patients presenting for evaluation of scrotal pathologies was analyzed for presentingcomplaints and ultrasound findings according to objectives of the study. Results: In total 210 cases were included in the study. The agewise categorization included pediatric population (14.3%) adult population (80.9%) and geriatric population (4.3%). Pain was the mostcommon presenting feature in all age. Other major presenting complaints included swelling, absent testis, history of trauma, lower urinarytract symptoms (LUTS), and infertility. Hydrocele was the most common finding overall. Other major ultrasound finding includedvaricocele, epididymo-orchitis, spermatocele, atrophic testis, undescended testis tumors and complications of trauma. Conclusions:Scrotal pathologies are among the frequently encountered problems in our region. Ultrasound is a sensitive and useful tool for evaluationof scrotal pathologies.


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