Fast Healthcare Interoperability Resources (FHIR) for Interoperability in Health Research: A Systematic Review (Preprint)

2021 ◽  
Author(s):  
Carina Nina Vorisek ◽  
Moritz Lehne ◽  
Sophie Anne Ines Klopfenstein ◽  
Alexander Bartschke ◽  
Thomas Haese ◽  
...  
Keyword(s):  
Public Health ◽  
Systematic Review ◽  
Health Research ◽  
Use Cases ◽  
Data Sources ◽  
Cochrane Library ◽  
Snomed Ct ◽  
Medical Specialties ◽  
Domain 3 ◽  
Public Health Epidemiology

BACKGROUND The standard Fast Healthcare Interoperability Resources (FHIR) is widely used in health information technology. However, its use as a standard for health research is still less prevalent. To use existing data sources more efficiently for health research, data interoperability becomes increasingly important. FHIR provides solutions by offering resource domains such as “Public Health & Research” and “Evidence-Based Medicine” while using already established web technologies. Therefore, FHIR could help to standardize data across different data sources and improve interoperability in health research. OBJECTIVE The aim of our study was to provide a systematic review of existing literature and determine the current state of FHIR implementations in health research and possible future directions. METHODS We searched PubMed/Medline, EMBASE, Web of Science, IEEE Xplore and the Cochrane Library databases for studies published from 2010 to 2021. Studies investigating the use of FHIR in health research were included. Articles published before 2010, abstracts, reviews, editorials and expert opinions were excluded. We followed the PRISMA guidelines and registered this study with PROSPERO, CRD42021235393. Data synthesis was done in tables and figures. RESULTS We identified a total of 674 studies, of which 28 studies were eligible for inclusion. Most studies covered the domain of clinical research (22/28) while the remaining studies focused on public health/ epidemiology (3/28) or did not specify their research domain (3/28). Studies used FHIR for data capture (11/28), standardization of data (7/28), analysis (4/28), recruitment (4/28) and consent management (2/28). Most studies had a generic approach (15/28) and nine of 13 studies focusing on specific medical specialties (infectious disease, genomics, oncology, environmental health, imaging, pulmonary hypertension) reported their solutions to be conferrable to other use cases. Half of the studies reported using additional data models or terminologies: SNOMED CT (8/14), LOINC (8/14), ICD-10 (6/14), OMOP CDM (3/14) and others (9/14). Only one study used a FHIR resource from the domain “Public Health & Research”. Limitations using FHIR included the possible change in the content of FHIR resources, safety and legal matters and the need for a FHIR server. CONCLUSIONS Our review found that FHIR can be implemented in health research and that the areas of application are broad and generalizable in most use cases. Implementation of international terminologies was common and other standards such as OMOP CDM could be used complementary with FHIR. Limitations such as change of FHIR content, lack of FHIR implementation, safety and legal matters need to be addressed in future releases to expand the use of FHIR and therefore interoperability in health research.

scholarly journals Prioritising recommendations following analyses of adverse events in healthcare: a systematic review

2020 ◽  
Vol 9 (4) ◽  
pp. e000843
Author(s):  
Kelly Bos ◽  
Maarten J van der Laan ◽  
Dave A Dongelmans
Keyword(s):  
Systematic Review ◽  
Adverse Events ◽  
Data Extraction ◽  
Data Sources ◽  
Cochrane Library ◽  
High Quality ◽  
Data Synthesis ◽  
Study Selection ◽  
Personal Opinion ◽  
User Friendly

PurposeThe purpose of this systematic review was to identify an appropriate method—a user-friendly and validated method—that prioritises recommendations following analyses of adverse events (AEs) based on objective features.Data sourcesThe electronic databases PubMed/MEDLINE, Embase (Ovid), Cochrane Library, PsycINFO (Ovid) and ERIC (Ovid) were searched.Study selectionStudies were considered eligible when reporting on methods to prioritise recommendations.Data extractionTwo teams of reviewers performed the data extraction which was defined prior to this phase.Results of data synthesisEleven methods were identified that are designed to prioritise recommendations. After completing the data extraction, none of the methods met all the predefined criteria. Nine methods were considered user-friendly. One study validated the developed method. Five methods prioritised recommendations based on objective features, not affected by personal opinion or knowledge and expected to be reproducible by different users.ConclusionThere are several methods available to prioritise recommendations following analyses of AEs. All these methods can be used to discuss and select recommendations for implementation. None of the methods is a user-friendly and validated method that prioritises recommendations based on objective features. Although there are possibilities to further improve their features, the ‘Typology of safety functions’ by de Dianous and Fiévez, and the ‘Hierarchy of hazard controls’ by McCaughan have the most potential to select high-quality recommendations as they have only a few clearly defined categories in a well-arranged ordinal sequence.

scholarly journals The time to act is now: pseudo-systematic review

BMJ ◽  
2020 ◽  
pp. m4143
Author(s):  
Nathan Ford ◽  
Grania Brigden ◽  
Tom Ellman ◽  
Edward J Mills
Keyword(s):  
Public Health ◽  
Systematic Review ◽  
Disease Burden ◽  
Data Sources ◽  
Study Selection

Abstract Objective To identify any medical or public health rationale for claims that the time to act is now. Design Pseudo-systematic review. Data sources PubMed. Study selection Studies that included the claim “time is now” in the title, with or without exclamation marks. No language or date restriction was applied. Results 512 articles were included for review. No relationship was identified between time to act and disease burden, severity, or specialty. Claims that the time to act was Christmas were almost entirely without basis. A clustering of claims that it is time to act in the first quarter of the year suggested a possible association with New Year’s resolutions. Conclusions Now is as good a time as any.

PP109 Use Of Speech Recognition In Medical Reports: A Systematic Review

2018 ◽  
Vol 34 (S1) ◽  
pp. 107-107
Author(s):  
Thomas Poder ◽  
Véronique Déry ◽  
Jean-Francois Fisette
Keyword(s):  
Systematic Review ◽  
Speech Recognition ◽  
Systematic Reviews ◽  
Grey Literature ◽  
Medical Doctor ◽  
Cochrane Library ◽  
Medical Specialties ◽  
Medical Reports ◽  
End Use

Introduction:Speech recognition is increasingly used in medical reporting. The aim of this article is to identify in the literature the advantages and weaknesses of this technology, as well as barriers and facilitators to its implementation.Methods:A systematic review of systematic reviews has been conducted in PubMed, Scopus, Cochrane Library and Center for Reviews and Dissemination up to August 2017. The grey literature has also been consulted. The quality of systematic reviews has been assessed with the AMSTAR checklist. Inclusion criteria were to use speech recognition for medical reporting (front or back-end). A Survey has also been conducted in Quebec, Canada, to identify the dissemination of this technology in this province, as well as the factors of success or failure in its implementation.Results:Five systematic reviews were identified. These reviews indicated a high level of heterogeneity across studies. The quality of the studies reported was generally poor. Speech recognition is not as accurate as human transcription but can dramatically reduce the turnaround times for reporting. In front-end use, medical doctors need to spend more time for dictation and correction than with human transcription. With speech recognition, major errors can be up to three times more frequent. In back-end use, a potential increase in the productivity of transcriptionist is noted.Conclusions:Speech recognition offers some advantages for medical reporting, the main one being a reduction in turnaround times. However, these advantages are challenged by an increased burden for medical doctor and risks of additional errors in medical reports. It is also hard to identify for which medical specialties and which clinical activities the use of speech recognition will be the most beneficial.

scholarly journals Digital and online symptom checkers and assessment services for urgent care to inform a new digital platform: a systematic review

2019 ◽  
Vol 7 (29) ◽  
pp. 1-88 ◽  
Author(s):  
Duncan Chambers ◽  
Anna Cantrell ◽  
Maxine Johnson ◽  
Louise Preston ◽  
Susan K Baxter ◽  
...  
Keyword(s):  
Systematic Review ◽  
Health Services ◽  
Health Problems ◽  
Data Sources ◽  
Urgent Care ◽  
Cochrane Library ◽  
Bibliographic Databases ◽  
Economic Evaluations ◽  
Small Scale ◽  
Digital Platform

Background Digital and online symptom checkers and assessment services are used by patients seeking guidance about health problems. NHS England is planning to introduce a digital platform (NHS111 Online) to operate alongside the NHS111 urgent-care telephone service. This review focuses on digital and online symptom checkers for urgent health problems. Objectives This systematic review was commissioned to provide NHS England with an independent review of previous research in this area to inform strategic decision-making and service design. Data sources Focused searches of seven bibliographic databases were performed and supplemented by phrase searching for names of symptom checker systems and citation searches of key included studies. The bibliographic databases searched were MEDLINE, EMBASE, The Cochrane Library, CINAHL (Cumulative Index to Nursing and Allied Health Literature), HMIC (Health Management Information Consortium), Web of Science and the Association of Computing Machinery (ACM) Digital Library, from inception up to April 2018. Review methods Brief inclusion criteria were (1) population – general population seeking information online or digitally to address an urgent health problem; (2) intervention – any online or digital service designed to assess symptoms, provide health advice and direct patients to appropriate services; and (3) comparator – telephone or face-to-face assessment, comparative performance in tests or simulations (studies with no comparator were included if they reported relevant outcomes). Outcomes of interest included safety, clinical effectiveness, costs or cost-effectiveness, diagnostic and triage accuracy, use of and contacts with health services, compliance with advice received, patient/carer satisfaction, and equity and inclusion. Inclusion was not restricted by study design. Screening studies for inclusion, data extraction and quality assessment were carried out by one reviewer with a sample checked for accuracy and consistency. Final decisions on study inclusion were taken by consensus of the review team. A narrative synthesis of the included studies was performed and structured around the predefined research questions and key outcomes. The overall strength of evidence for each outcome was classified as ‘stronger’, ‘weaker’, ‘conflicting’ or ‘insufficient’, based on study numbers and design. Results In total, 29 publications describing 27 studies were included. Studies were diverse in their design and methodology. The overall strength of the evidence was weak because it was largely based on observational studies and with a substantial component of non-peer-reviewed grey literature. There was little evidence to suggest that symptom checkers are unsafe, but studies evaluating their safety were generally short term and small scale. Diagnostic accuracy was highly variable between different systems but was generally low. Algorithm-based triage tended to be more risk averse than that of health professionals. Inconsistent evidence was found on effects on service use. There was very limited evidence on patients’ reactions to online triage advice. The studies showed that younger and more highly educated people are more likely to use these services. Study participants generally expressed high levels of satisfaction with digital and online triage services, albeit in uncontrolled studies. Limitations Findings from symptom checker systems for specific conditions may not be applicable to more general systems and vice versa. Studies of symptom checkers as part of electronic consultation systems in general practice were also included, which is a slightly different setting from a general ‘digital 111’ service. Most studies were screened by one reviewer. Conclusions Major uncertainties surround the probable impact of digital 111 services on most outcomes. It will be important to monitor and evaluate the services using all available data sources and by commissioning high-quality research. Future work Priorities for research include comparisons of different systems, rigorous economic evaluations and investigations of patient pathways. Study registration The study is registered as PROSPERO CRD42018093564. Funding The National Institute for Health Research Health Services and Delivery Research programme.

scholarly journals Completeness of Retention Data and Determinants of Attrition in Birth Cohorts of Very Preterm Infants: A Systematic Review

2021 ◽  
Vol 9 ◽  
Author(s):  
Raquel Teixeira ◽  
Ana Catarina Queiroga ◽  
Ana Isabel Freitas ◽  
Elsa Lorthe ◽  
Ana Cristina Santos ◽  
...  
Keyword(s):  
Public Health ◽  
Systematic Review ◽  
Preterm Infants ◽  
Polynomial Regression ◽  
Cochrane Library ◽  
Retention Data ◽  
Birth Cohorts ◽  
Very Preterm Infants ◽  
Very Preterm

Background: Birth cohorts provided essential knowledge for clinical and public health decision-making. However, little is known about retention and determinants of attrition in these specific longitudinal studies, although characterizing predictors of attrition sets the path to mitigate its occurrence and to promote valid inferences. We systematically reviewed retention in follow-ups of birth cohorts of very preterm or very low birth weight infants and the determinants of attrition. PROSPERO registration number: CRD42017082672.Methods: Publications were identified through PubMed®, Scopus, Web of Science, and Cochrane Library databases from inception to December 2017. Studies were included when reporting at least one of the following: retention at follow-ups, reasons for attrition, or characteristics of non-participants. Quality assessment was conducted using the completeness of the report of participation features in the articles. Non-participant's characteristics were presented using descriptive statistics. Local polynomial regression was used to describe overall retention trends over years of follow-up.Results: We identified 57 eligible publications, reporting on 39 birth cohorts and describing 83 follow-up evaluations. The overall median retention was 87% (p25–p75:75.8–93.6), ranging from 14.6 to 100%. Overall, retention showed a downward trend with increasing child age. Completeness of retention report was considered “enough” in only 36.8% of publications. Considering the 33 (57.9%) publications providing information on participants and non-participants, and although no formal meta-analysis was performed, it was evident that participants lost to follow-up were more often male, had foreign-born, multiparous, and younger mothers, and with a lower socioeconomic status.Conclusion: This systematic review evidenced a lack of detailed data on retention, which may threaten the potential use of evidence derived from cohort studies of very preterm infants for clinical and public health purpose. It supports the requirement for a standardized presentation of retention features responding to current guidelines.

scholarly journals Protocol for a systematic review of the use of qualitative comparative analysis for evaluative questions in public health research

2019 ◽  
Vol 8 (1) ◽  
Author(s):  
Benjamin Hanckel ◽  
Mark Petticrew ◽  
James Thomas ◽  
Judith Green
Keyword(s):  
Public Health ◽  
Systematic Review ◽  
Comparative Analysis ◽  
Health Research ◽  
Citation Index ◽  
Qualitative Comparative Analysis ◽  
Public Health Intervention ◽  
Public Health Research ◽  
Intervention Research ◽  
Health Intervention

Abstract Background There is an increasing recognition that health intervention research requires methods and approaches that can engage with the complexity of systems, interventions, and the relations between systems and interventions. One approach which shows promise to this end is qualitative comparative analysis (QCA), which examines casual complexity across a medium to large number of cases (between 10 and 60+), whilst also being able to generalise across those cases. Increasingly, QCA is being adopted in public health intervention research. However, there is a limited understanding of how it is being adopted. This systematic review will address this gap, examining how it is being used to understand complex causation; for what settings, populations and interventions; and with which datasets to describe cases. Methods We will include published and peer-reviewed studies of any public health intervention where the effects on population health, health equity, or intervention uptake are being evaluated. Electronic searches of PubMed, Scopus, Web of Science (incorporating Social Sciences Citation Index and Arts & Humanities Citation Index), Microsoft Academic, and Google Scholar will be performed. This will be supplemented with reference citation tracking and personal contact with experts to identify any additional published studies. Search results will be single screened, with machine learning used to check these results, acting as a ‘second screener’. Any disagreement will be resolved through discussion. Data will be extracted from full texts of eligible studies, which will be assessed against inclusion criteria, and synthesised narratively, using thematic synthesis methods. Discussion This systematic review will provide an important map of the increasing use of QCA in public health intervention literature. This review will identify the current scope of research in this area, as well as assessing claims about the utility of the method for addressing complex causation in public health research. We will identify implications for better reporting of QCA methods in public health research and for reporting of case studies such that they can be used in future QCA studies. Systematic review registration PROSPERO, CRD42019131910

scholarly journals The quality of reports of medical and public health research from Palestinian institutions: a systematic review

BMJ Open ◽  
2017 ◽  
Vol 7 (6) ◽  
pp. e016455 ◽  
Author(s):  
Loai Albarqouni ◽  
Niveen ME Abu-Rmeileh ◽  
Khamis Elessi ◽  
Mohammad Obeidallah ◽  
Espen Bjertness ◽  
...  
Keyword(s):  
Public Health ◽  
Systematic Review ◽  
Health Research ◽  
Public Health Research ◽  
Quality Of Reports

scholarly journals Health-related outcomes of new grocery store interventions: a systematic review

2017 ◽  
Vol 20 (12) ◽  
pp. 2236-2248 ◽  
Author(s):  
AM Hasanthi Abeykoon ◽  
Rachel Engler-Stringer ◽  
Nazeem Muhajarine
Keyword(s):  
Public Health ◽  
Systematic Review ◽  
Psychological Health ◽  
Methodological Quality ◽  
Food Access ◽  
Vegetable Consumption ◽  
Grocery Store ◽  
Cochrane Library ◽  
Health Related ◽  
The Impact

AbstractObjectiveTo assess the evidence of the impact of new food store (supermarket/grocery store) interventions on selected health-related outcomes.DesignA systematic review following the Effective Public Health Practice Project guidelines. All quantitative studies were assessed for their methodological quality. Results were synthesized narratively.SettingEight electronic databases – MEDLINE, EMBASE, CINAHL, ProQuest Public Health, Web of Science, Scopus, PsycINFO and Cochrane Library – were searched to identify relevant records.SubjectsPeer-reviewed scholarly journal articles on new grocery store/supermarket interventions with adult study populations, published in the English language after 1995.ResultsEleven records representing seven new grocery store interventions were identified. Six were assessed having ‘weak’ methodological quality, one as ‘moderate’ and two as ‘strong’. All studies reported fruit and vegetable consumption but results were not consistent, some studies reporting significantly more and others no increase in consumption. BMI and self-rated health did not show significant improvements. Perceptions of food access, neighbourhood satisfaction and psychological health showed significant improvements.ConclusionsImproved food access through establishment of a full-service food retailer, by itself, does not show strong evidence towards enhancing health-related outcomes over short durations. Presently the field is developing and the complex linking pathways/mechanisms are yet to be elucidated. Further evidence, in the form of high-quality research in different communities with longer follow-up periods, is needed to inform policy decisions.

Completeness of reporting in Indian qualitative public health research: a systematic review of 20 years of literature

2018 ◽  
Vol 41 (2) ◽  
pp. 405-411 ◽  
Author(s):  
Myron Anthony Godinho ◽  
Nachiket Gudi ◽  
Maja Milkowska ◽  
Shruti Murthy ◽  
Ajay Bailey ◽  
...  
Keyword(s):  
Public Health ◽  
Systematic Review ◽  
Qualitative Research ◽  
Health Research ◽  
English Language ◽  
Public Health Research ◽  
Descriptive Statistics ◽  
Search Results ◽  
Time Periods ◽  
Completeness Of Reporting

Abstract Background This study reviewed the completeness of reporting in Indian qualitative public health research (QPHR) studies using the ‘Consolidated Criteria for Reporting Qualitative Research’ (COREQ) checklist. Methods Search results from five electronic databases were screened by two independent reviewers. We included English-language, primary QPHR studies from India, which were assessed for their compliance with the COREQ checklist. Each COREQ item was noted as either reported or unreported. Descriptive statistics for the number of COREQ items reported by each study, and the number of studies that reported each COREQ item were reported, as were the items reported in each year, and in pre- and post-COREQ time periods. Results Of 537 citations, 246 articles were included. Trends demonstrated an increasing number of Indian QPHR studies being published annually, and an overall increase in reporting completeness since 1997. Only two COREQ items were reported in all studies. 52.4% of articles reported between 16 and 21 items, corresponding to 43–57% of items being reported. Six items were reported in fewer than 10% of studies. COREQ domain 1 was least frequently reported. Conclusions Despite improving trends, the reporting of QPHR in India is incomplete. Authors and journals should ensure adherence to reporting guidelines.

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