Perceived Risk of Re-identification in OMOP-CDM Database: A Cross-Sectional Survey (Preprint)

2021 ◽  
Author(s):  
Yae Won Tak ◽  
Seng Chan Yu ◽  
Jeong Hyun Han ◽  
Soon-Seok Kim ◽  
Gi-Tae Kim ◽  
...  
Keyword(s):  
Perceived Risk ◽  
High Reliability ◽  
Unstructured Data ◽  
Research Network ◽  
Common Data Model ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Intrinsic Nature ◽  
Level Data ◽  
Privacy Measures

BACKGROUND The advancement of information technology has immensely increased the quality and volume of health data. This has led to an increase in observational study, as well as to the threat of privacy invasion. Recently, a distributed research network based on the common data model (CDM) has emerged, enabling collaborative international medical research without sharing patient-level data. Although the CDM database for each institution is built inside a firewall, the risk of re-identification requires management. OBJECTIVE This study aims to elucidate the perceptions CDM users have towards CDM and risk management for re-identification. METHODS The survey, targeted to answer specific in-depth questions on CDM, was conducted from October - November 2020. We targeted well-experienced researchers who actively use CDM. Basic statistics (total number and percent) were computed for all covariates. RESULTS There were 33 valid respondents. Of these, 43.8% demonstrated supplementary privacy measures were unnecessary, as the “minimum cell count” parameter was effective in minimizing the liability of re-identification. During extract-transform-load processes, 81.8% of respondents assumed structured data is under control from the risk of re-identification. However, respondents noted that date of birth and death were highly re-identifiable information. The majority of respondents (n=22, 66.7%) conceded the possibility of identifier-contained unstructured data in the NOTE table. CONCLUSIONS Overall, CDM users generally attributed high reliability for privacy protection to the intrinsic nature of CDM. There was little demand for additional de-identification methods. However, unstructured data in the CDM were suspected to have risks. The necessity for a coordinating consortium to define and manage the re-identification risk of CDM was urged.

Risk Minimization Measures in Off-Label Drug Use: A Survey of Community Pharmacists in Malaysia

2020 ◽  
Vol 15 (3) ◽  
pp. 181-189
Author(s):  
Omotayo Fatokun
Keyword(s):  
Informed Consent ◽  
Drug Use ◽  
Perceived Risk ◽  
Adverse Drug Events ◽  
Community Pharmacists ◽  
Risk Minimization ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Off Label ◽  
Written Informed Consent

Background: While off-label drug use is common and sometimes necessary, it also presents considerable risks. Therefore, measures intended to prevent or reduce the potential exposure to off-label risks have been recommended. However, little is known about community pharmacists’ beliefs regarding these measures in Malaysia. Objectives: This study examined community pharmacists’ beliefs towards risk minimization measures in off-label drug use in Malaysia and assessed the relationship between perceived risk of off-label drug use and beliefs towards risk minimization measures. Methods: A cross-sectional survey was conducted among 154 pharmacists practicing in randomly selected community pharmacies in Kuala Lumpur and the State of Selangor, Malaysia. Results: The majority agreed or strongly agreed that adverse drug events from the off-label drug should be reported to the regulatory authority (90.9%) and the off-label drug should only be used when the benefit outweighs potential risks (88.3%). Less than half (48.1%) agreed or strongly agreed that written informed consent should be obtained before dispensing off-label drugs and a majority (63.7%) agreed or strongly agreed that the informed consent process will be burdensome to healthcare professionals. Beliefs towards risk minimization measures were significantly associated with perceived risk of off-label drug use regarding efficacy (p = 0. 033), safety (p = 0.001), adverse drug rection (p = 0.001) and medication errors (p = 0.002). Conclusion: The community pharmacists have positive beliefs towards most of the risk minimization measures. However, beliefs towards written informed consent requirements are not encouraging. Enhancing risk perception may help influence positive beliefs towards risk minimization measures.

Interfacility transfer communication of multidrug-resistant organism colonization or infection status: Practices and barriers in the acute-care setting

2021 ◽  
pp. 1-6
Author(s):  
Katherine D. Ellingson ◽  
Brie N. Noble ◽  
Genevieve L. Buser ◽  
Graham M. Snyder ◽  
Jessina C. McGregor ◽  
...  
Keyword(s):  
Acute Care ◽  
Infection Prevention ◽  
Multidrug Resistant ◽  
Research Network ◽  
Resistant Organism ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Hospital Size ◽  
Academic Affiliation ◽  
Healthcare Epidemiology

Abstract Objective: To describe interfacility transfer communication (IFTC) methods for notification of multidrug-resistant organism (MDRO) status in a diverse sample of acute-care hospitals. Design: Cross-sectional survey. Participants: Hospitals within the Society for Healthcare Epidemiology of America (SHEA) Research Network (SRN). Methods: SRN members completed an electronic survey on protocols and methods for IFTC. We assessed differences in IFTC frequency, barriers, and perceived benefit by presence of an IFTC protocol. Results: Among 136 hospital representatives who were sent the survey, 54 (40%) responded, of whom 72% reported having an IFTC protocol in place. The presence of a protocol did not differ significantly by hospital size, academic affiliation, or international status. Of those with IFTC protocols, 44% reported consistent notification of MDRO status (>75% of the time) to receiving facilities, as opposed to 13% from those with no IFTC protocol (P = .04). Respondents from hospitals with IFTC protocols reported significantly fewer barriers to communication compared to those without (2.8 vs 4.3; P = .03). Overall, however, most respondents (56%) reported a lack of standardization in communication. Presence of an IFTC protocol did not affect whether respondents perceived IFTC protocols as having a significant impact on infection prevention or antimicrobial stewardship. Conclusions: Most respondents reported having an IFTC protocol, which was associated with reduced communication barriers at transfer. Standardization of protocols and clarity about expectations for sending and receipt of information related to MDRO status may facilitate IFTC and promote appropriate and timely infection prevention practices.

scholarly journals Common Barriers, Attitudes, and Practices of Veterinary Practitioners Regarding Antimicrobial Resistance and Stewardship in Chattogram, Bangladesh

2021 ◽  
Vol 2 (1) ◽  
pp. 72-80
Author(s):  
Md. Sahidur Rahman ◽  
Nazifa Rafa
Keyword(s):  
Antimicrobial Resistance ◽  
Perceived Risk ◽  
Categorical Variables ◽  
Local Market ◽  
Large Animal ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Attitudes And Practices ◽  
Severity Of The Disease ◽  
Antimicrobial Treatments

Abstract The perceived risk of antimicrobial-resistant pathogens creates the necessity for understanding the role of the prescriber groups. Hence, we conducted a cross-sectional survey among veterinary practitioners to assess their understanding regarding antimicrobial prescribing and the issue of antimicrobial resistance (AMR) in livestock. We collected responses from 100 veterinarians engaged in the large animal, poultry, and pet animal care practices. Proportions were calculated for categorical variables and the results were visualized. We revealed two key barriers: a lack of enough information and of training on the proper prescription of antimicrobials. Prescribing a wide variety of antimicrobials and doing incomplete courses of antimicrobial treatments were two very important causes pointed out by the respondents for the development of antimicrobial resistance. A number of highest-priority critically important antimicrobials (HP-CIAs) of human health were found to be used by veterinary practitioners. In addition to clinical features like types of organisms and severity of the disease, the availability of drugs in the local market and the economic conditions of farmers have the potential to influence the decisions of veterinarians in prescribing antimicrobials. The professional development of veterinarians and the maintenance of strong coordination are crucial to ensure the proper engagement of veterinarians as the front-line fighters for tackling the AMR issue.

scholarly journals Acceptability of the Coronavirus Disease-2019 Vaccine Among Medical Students in Uganda: a Cross Sectional Study.

2021 ◽  
Author(s):  
Andrew Marvin Kanyike ◽  
Ronald Olum ◽  
Jonathan Kajjimu ◽  
Daniel Ojilong ◽  
Grabriel Madut Akech ◽  
...  
Keyword(s):  
Medical Students ◽  
Perceived Risk ◽  
Cross Sectional Study ◽  
Vaccine Hesitancy ◽  
Cross Sectional Survey ◽  
Future Health ◽  
Vaccine Acceptability ◽  
Cross Sectional ◽  
The Future ◽  
Global Threat

Abstract Background COVID-19 is still a major global threat and vaccination remains the long-lasting solution. Unanimous uptake of the COVID-19 vaccine is required to subsequently avert its spread. We therefore, assessed COVID-19 vaccine acceptability, hesitancy, and associated factors among medical students in Uganda. Methods This study employed an online descriptive cross-sectional survey among medical students across 10 medical schools in Uganda. A structured questionnaire as a Google form was sent to participants via WhatsApp. Data was extracted and analyzed using Microsoft Excel 2016 and STATA 16. Descriptive statistics, bivariate and multivariable analyses were performed. Results We surveyed 600 medical students, 377 (62.8%) were male. COVID-19 vaccine hesitancy and acceptability were 30.7% and 37.3%, respectively. Factors associated with vaccine acceptability were being female (aOR = 1.9, 95% CI: 1.3–2.9, p = 0.001), being single (aOR = 2.1, 95% CI 1.1–3.9, p = 0.022). Very high (aOR = 3.5, 95% CI 1.7–6.9, p < 0.001) or moderate (aOR = 2.2, 95% CI 1.2–4.1, p = 0.008) perceived risk of getting COVID-19 in the future, receiving any vaccine in the past 5 years (aOR = 1.6, 95% CI 1.1–2.5, p = 0.017), and COVID-19 vaccine hesitancy (aOR 0.6, 95% CI 0.4–0.9, p = 0.036). Conclusions This study revealed low levels of acceptance towards the COVID-19 vaccine among medical students, low self-perceived risks of COVID-19, and many had relied on social media that provided them with negative information. This poses an evident risk on the battle towards COVID-19 in the future especially when these future health professions are expected to be influencing decisions of the general public towards the same.

Perceptions of people who inject drugs towards HIV pre-exposure prophylaxis in Australia

Sexual Health ◽  
2019 ◽  
Vol 16 (4) ◽  
pp. 383
Author(s):  
Phillip Read ◽  
Karen J. Chronister ◽  
Catherine Kostovski ◽  
Mary Ellen Harrod ◽  
Allison Salmon ◽  
...  
Keyword(s):  
Perceived Risk ◽  
Policy Development ◽  
People Who Inject Drugs ◽  
Hiv Status ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Willingness To Use ◽  
Exposure Prophylaxis ◽  
Current Guidelines ◽  
Hiv Negative

Background People who inject drugs (PWID) are a priority for HIV prevention. This study aimed to determine perceptions, potential eligibility and willingness to use PrEP among PWID in Sydney. Methods: Clients completed a cross-sectional survey to collect data on demographics, perceived risk of HIV and willingness to use PrEP, which were then analysed. Results: Twelve (7%) of 172 HIV-negative participants were eligible for PrEP under current guidelines for injecting reasons, of whom three would also be eligible for sexual risk, leaving nine (5%) eligible for injecting reasons alone. Half had heard of PrEP and, of these, 65% would consider taking it. Most (88%) thought they would continue using needle syringe program services. A minority (8%) indicated they may be likely to share needles and syringes or be less concerned about injecting partners’ HIV status (26%). Conclusions: Although PrEP will benefit a small proportion of PWID, this may equate to a significant number nationally. Policy development around PrEP incorporating affected populations will best support the community of people currently injecting to keep rates of HIV low.

Characterization of nurses’ duty to care and willingness to report

2019 ◽  
Vol 27 (2) ◽  
pp. 348-359 ◽  
Author(s):  
Charleen McNeill ◽  
Danita Alfred ◽  
Tracy Nash ◽  
Jenifer Chilton ◽  
Melvin S Swanson
Keyword(s):  
Research Design ◽  
Perceived Risk ◽  
The United States ◽  
Discussion Board ◽  
Care Group ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Convenience Sample ◽  
The University ◽  
Willingness To Report

Background: Nurses must balance their perceived duty to care against their perceived risk of harm to determine their willingness to report during disaster events, potentially creating an ethical dilemma and impacting patient care. Research aim: The purpose of this study was to investigate nurses’ perceived duty to care and whether there were differences in willingness to respond during disaster events based on perceived levels of duty to care. Research design: A cross-sectional survey research design was used in this study. Participants and research context: Using a convenience sample with a snowball technique, data were collected from 289 nurses throughout the United States in 2017. Participants were recruited through host university websites, Facebook, and an American Nurses Association discussion board. Ethical considerations: Institutional review board approval was obtained from the University of Texas at Tyler and the University of Arkansas. Findings: Analysis of willingness to report to work based on levels of perceived duty to care resulted in the emergence of two groups: “lower level of perceived duty to care group” and “higher level of perceived duty to care group.” The most discriminating characteristics differentiating the groups included fear of abandonment by co-workers, reporting because it is morally the right thing to, and because of imperatives within the Nursing Code of Ethics. Discussion: The number of nurses in the lower level of perceived duty to care group causes concern. It is important for nursing management to develop strategies to advance nurses’ safety, minimize nurses’ risk, and promote nurses’ knowledge to confidently work during disaster situations. Conclusion: Level of perceived duty to care affects nurses’ willingness to report to work during disasters. Primary indicators of low perceived duty to care are amenable to actionable strategies, potentially increasing nurses’ perceived duty to provide care and willingness to report to work during disasters.

Australian osteopaths as non-medical prescribers: comparison of healthcare practitioner characteristics from a nationally representative survey

2020 ◽  
Vol 26 (5) ◽  
pp. 417
Author(s):  
Brett Vaughan ◽  
Michael Fleischmann ◽  
Kylie Fitzgerald ◽  
Sandra Grace ◽  
Paul Orrock ◽  
...  
Keyword(s):  
Diagnostic Imaging ◽  
Patient Management ◽  
Secondary Analysis ◽  
Research Network ◽  
Scope Of Practice ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
The Future ◽  
Practice Based Research ◽  
Nationally Representative

The study aimed to compare the characteristics of Australian osteopaths who definitely agree that prescribing scheduled medicines is part of their future scope of practice with those who do not. A secondary analysis of a cross-sectional survey of osteopaths from an Australian practice-based research network was undertaken. Demographic, practice and treatment characteristics were identified using inferential statistics and backward linear regression modelling. Over one-quarter (n=257, 25.9%) of the total participants (n=992) indicated that they ‘definitely’ agree that osteopaths should seek prescription rights. Adjusted odds ratios (OR) suggested these osteopaths were more likely to engage in medication discussions with patients (OR 1.88), frequently manage migraines (OR 1.68) and seek increased practice rights for referrals to medical specialists (OR 2.61) and diagnostic imaging (OR 2.79). Prescribing as part of the future scope of practice for Australian osteopaths is associated with patient management (medication discussions) and practice characteristics (increased referral rights for specialists and diagnostic imaging) that warrant additional investigation. Understanding of the practice, clinical and patient management characteristics of Australian osteopaths who see prescribing as part of the future scope of practice informs the case for regulatory and health policy changes for prescribing scheduled medicines.

Intensity and treatment of symptoms in 3,030 palliative care patients: A cross-sectional survey of the EAPC Research Network

2018 ◽  
Vol 5 (1) ◽  
pp. 11 ◽  
Author(s):  
Eivor Alette Laugsand, PhD-student ◽  
Stein Kaasa, MD ◽  
Franco De Conno, MD ◽  
Geoffrey Hanks, MD ◽  
Pål Klepstad, MD
Keyword(s):  
Palliative Care ◽  
Symptom Management ◽  
Specific Treatment ◽  
Research Network ◽  
Poor Sleep ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Symptom Intensity ◽  
Who Pain Ladder ◽  
Prescription Practice

Objective: This study aimed to describe intensity and treatment of symptoms other than pain in European palliative care units.Patients: A total of 3,030 patients, including 2,064 that used an opioid, were included from 143 palliative care centers, in 21 European countries.Results: Pain was treated with analgesics corresponding to the WHO pain ladder step I (n = 374), II (n = 497), and III (n = 1,567). Frequencies of symptoms observed as moderate or severe were for generalized weakness (50 percent), fatigue (48 percent), anxiety (28 percent), anorexia (26 percent), constipation (18 percent), focal weakness (18 percent), depression (18 percent), and dyspnoea (15 percent). When comparing WHO-groups, cancer diagnoses, metastasis sites, countries, and genders, we found that some of the symptom intensities and treatments differed significantly between subgroups. A majority of patients used drugs for symptom management. Still, more than one-third of patients assessed to have moderate or severe constipation did not receive any treatment. The corresponding numbers for depression, confusion, nausea, vomiting, or anxiety were approaching 40 percent and for poor sleep about 50 percent. Prescription practice of antiemetics, laxatives, and psychotropic drugs varied widely between countries both in terms of preparation and percent of patients receiving a specific treatment.Conclusions: This survey shows that clinically relevant symptoms are frequent and that one-third to half of the patients with a symptom observed as moderate or severe do not receive any treatment aimed to reduce the symptom intensity. Several symptoms and treatments differed between WHO-groups, cancer diagnoses, metastasis locations, countries, and genders. Prescription practice varied between countries both in terms of medication administered and percent of patients receiving specific treatment.

scholarly journals 542. Los Angeles County Acute Care Regional Antibiogram Suggests Changing Landscape of MDRO Threats Between 2015 and 2017

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S258-S259
Author(s):  
James McKinnell ◽  
Chelsea Foo ◽  
Kelsey OYong ◽  
Janet Hindler ◽  
Sandra Ceja ◽  
...  
Keyword(s):  
Public Health ◽  
Los Angeles ◽  
Acute Care ◽  
Los Angeles County ◽  
Multivariable Analysis ◽  
Multidrug Resistant ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Level Data ◽  
Facility Level

Abstract Background National surveillance for multidrug-resistant organisms (MDRO) are limited by narrow geographic sampling, few hospitals, and failure to account for local epidemiology. A Los Angeles County (LAC) regional antibiogram was created to inform public health interventions and provide a baseline for susceptibility patterns countywide. We present data to compare the 2015 and 2017 LAC regional antibiogram. Methods We conducted a cross-sectional survey of cumulative facility-level antibiograms from all hospitals in LAC; 83 hospitals (AH) and 9 Long-term Acute Care (LTAC). For 2015, submission was voluntary, 2017 data were collected by public health order. Non-respondents were contacted by phone and in person. Isolates from sterile sources were pooled. Countywide susceptibility was calculated by weighting each facility’s isolate count by its reported susceptibility rate with minimum–maximim observed (2015) and Interquartile range (IQR) for 2017. Change from 2015 mean susceptibility is reported. Results Seventy-five (75) facilities submitted antibiograms for 2015 and 86 facilities for 2017. Among non-respondents in 2017, two facilities could not provide an adequate antibiogram and 4 were specialty hospitals with too few cultures to create an antibiogram. Regional summmary tables are presented in Tables 1–4. Klebsiella pneumoniae (n = 50 hospitals/19,382 isolates) % S to meropenem was 97% (IQR 94–100%), no change from 2015. Pseudomonas aeruginosa (PA) (n = 52 hospitals/17,770 isolates)% S to meropenem was 84% (IQR 74–93%), no change from 2015. Susceptibility to Acinetobacter baumannii (AB) was reported by 48 hospitals, including 1,4361 isolates,% S to meropenem was 39% (IQR 25–75%), 14% lower than 2015. Streptococcus agalactiae (n = 13 hospitals/647 isolates)% S to clindamycin was 43% (IQR 13–59%), a 22% increase from 2015. Conclusion LAC regional antibiograms identified stable patterns of antimicrobial resistance for most pathogens, but concerning results with AB and PA. Analysis of highly drug-resistant pathogens such as AB and PA would be improved with patient-level data to generate a combination antibiogram. We favor presenting IQR %S as done for 2017. Ongoing analysis will include multivariable analysis of observed changed S controlling for hospital characteristics. Disclosures All authors: No reported disclosures.

Adoption of immuno-oncology in NSCLC, a real-world study in EU5.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e20631-e20631
Author(s):  
Alejandra Martinez De Pinillos ◽  
Isabel Ricote Lobera ◽  
Cristina Martinez ◽  
Caroline Anger ◽  
Filippo Guglielmetti ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Real World ◽  
Performance Status ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Patient Profile ◽  
Period 2 ◽  
Level Data ◽  
The Impact ◽  
New Evidence

e20631 Background: To date, there are no robust studies in real world practice describing the use of IO (immuno-oncology) treatments in advanced/metastatic (adv/m) NSCLC. The available evidence in Europe is limited to observational studies of small size. This study aims to understand the impact of IO in adv/mNSCLC and study the profile of patients currently receiving these treatments. Methods: 20,157 cases of 1st and 2nd line adv/mNSCLC patients between October 2016 and September 2018 in EU5 (France, Germany, Spain, Italy, UK) were identified within Oncology Dynamics, an IQVIA oncology syndicated cross sectional survey collecting anonymized patient-level data. Patient profile was described, and two groups were created to assess differences in the use of IO treatments (nivolumab, pembrolizumab, atezolizumab, ipilimumab, durvalumab) across 2 time periods: #1 October 2016 - September 2017 (n = 9,310); #2 October 2017 - September 2018 (n = 10,847). Results: IO treatments increased 15% in 1st line adv/mNSCLC (13% in non-squamous and 23% in squamous histology) and 11% in 2nd line across periods; reaching treatment shares of 20.3% and 67.9% in 1st line and 2nd line in Period 2. Within IO-treated patients, 9.5% in 1st line and 13.6% in 2nd line had ECOG ≥2, and 27% were > 71 years old. The use of IO in 1st line patients without mutations (EGFR/ALK/ROS1/BRAF) increased by 24%, while standard chemotherapy decreased by 21%. Conclusions: IO treatments had a rapid adoption in Europe last year, influenced by its approval in 1st line adv/mNSCLC and by clinical guidelines recommendations. Ongoing clinical trials may suggest a growing trend in the future that could potentially impact in healthcare systems. In addition, real world patients treated with IO are older and have a worse performance status than those widely included in clinical trials. An evaluation of these results sheds light into IO treatments in NSCLC and may contribute to the design of real-world studies to generate new evidence and optimize the use of these class of drugs in clinical practice.[Table: see text]

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