scholarly journals Sequence2Script: A Web-Based Tool for Translation of Pharmacogenetic Data Into Evidence-Based Prescribing Recommendations

2021 ◽  
Vol 12 ◽  
Author(s):  
Chad A. Bousman ◽  
Patrick Wu ◽  
Katherine J. Aitchison ◽  
Tony Cheng
Keyword(s):  
Healthcare Providers ◽  
Evidence Based ◽  
Clinical Report ◽  
Web Based ◽  
Case Examples ◽  
Laboratory Staff ◽  
Regulatory Standards ◽  
Wide Range ◽  
Development Plans ◽  
User Groups

Pharmacogenomic (PGx) testing has emerged as an effective strategy for informing drug selection and dosing. This has led to an increase in the use of PGx testing in the clinic and has catalyzed the emergence of a burgeoning commercial PGx testing industry. However, not all PGx tests are equivalent in their approach to translating testing results into prescribing recommendations, due to an absence of regulatory standards. As such, those generating and using PGx data require tools for ensuring the prescribing recommendations they are provided align with current peer-reviewed PGx-based prescribing guidelines developed by expert groups or approved product labels. Herein, we present Sequence2Script (sequence2script.com), a simple, free, and transparent web-based tool to assist in the efficient translation of PGx testing results into evidence-based prescribing recommendations. The tool was designed with a wide-range of user groups (e.g., healthcare providers, laboratory staff, researchers) in mind. The tool supports 97 gene-drug pairs with evidence-based prescribing guidelines, allows users to adjust recommendations for concomitant inhibitors and inducers, and generates a clinical report summarizing the patient’s genotype, inferred phenotype, phenoconverted phenotype (if applicable), and corresponding prescribing recommendations. In this paper, we describe each of the tool’s features, provide use case examples, and discuss limitations of and future development plans for the tool. Although we recognize that Sequecnce2Script may not meet the needs of every user, the hope is that this novel tool will facilitate more standardized use of PGx testing results and reduce barriers to implementing these results into practice.

scholarly journals Communicating public avalanche warnings – what works?

2018 ◽  
Vol 18 (9) ◽  
pp. 2537-2559 ◽  
Author(s):  
Rune V. Engeset ◽  
Gerit Pfuhl ◽  
Markus Landrø ◽  
Andrea Mannberg ◽  
Audun Hetland
Keyword(s):  
Web Based ◽  
The Public ◽  
Preparedness Planning ◽  
Modes Of Presentation ◽  
Wide Range ◽  
Hazard Warnings ◽  
Previous Decade ◽  
User Groups ◽  
Technical Details ◽  
Avalanche Warning

Abstract. Like many other mountainous countries, Norway has experienced a rapid increase in both recreational winter activities and fatalities in avalanche terrain during the past few decades: during the decade 2008–2017, 64 recreational avalanche fatalities were recorded in Norway. This is a 106 % increase from that of the previous decade. In 2013, Norway therefore launched the National Avalanche Warning Service (NAWS), which provides avalanche warnings to transport and preparedness authorities and to the public. Previous studies suggest that avalanche warnings are used extensively in trip and preparedness planning and have a relatively strong influence on the decisions people make in order to reduce risk. However, no evaluation concerning how efficiently the warnings are communicated and understood has been done to date in Norway. Avalanche warnings communicate complex natural phenomena with a variable complexity and level of uncertainty about both the future and the present. In order to manage avalanche risk successfully, it is fundamental that the warning message can be understood and translated into practice by a wide range of different user groups. Users with little or no avalanche competence may need simple information to decide when to stay away from avalanche terrain, while professional users may need advanced technical details in order to make their decisions. To evaluate how different modes of communication are understood, and how efficiently the informational content is communicated, we designed and implemented a web-based user survey. The modes of presentation were based on the Varsom.no 2017 version (Varsom.no being the national portal for natural hazard warnings in Norway). We first used a panel of 110 experts from NAWS to answer the survey, and used their answers to establish the indented message of the avalanche warning. We thereafter received responses from 264 users and compared their answers to those of the NAWS experts for the different modes of communication. We developed a method, the comprehension effectiveness score, to test the comprehension. Our empirical analyses suggest that most users find the warning service to be useful and well suited to their needs. However, the effectiveness of a warnings seems to be influenced by the competency of the user and the complexity of the scenarios. We discuss the findings and make recommendations on how to improve communication of avalanche warnings.

scholarly journals Communicating public avalanche warnings – what works?

2018 ◽  
Author(s):  
Rune V. Engeset ◽  
Gerit Pfuhl ◽  
Markus Landrø ◽  
Andrea Mannberg ◽  
Audun Hetland
Keyword(s):  
Web Based ◽  
The Public ◽  
Preparedness Planning ◽  
Modes Of Presentation ◽  
Warning Message ◽  
Wide Range ◽  
Previous Decade ◽  
User Groups ◽  
Technical Details ◽  
Avalanche Warning

Abstract. Like many other mountainous countries, Norway has experienced a rapid increase in both recreational winter activities, and fatalities, in avalanche terrain during the past few decades: during the decade 2008–2017, 64 recreational avalanche fatalities were recorded in Norway. This is a 106 % increase from that of the previous decade. In 2013, Norway therefore launched the National Avalanche Warning Service (NAWS), which provide avalanche warnings to transport and preparedness authorities, and to the public. Previous studies suggest that avalanche warnings are used extensively in trip and preparedness planning, and have a relatively strong influence on the decisions people are taking in order to reduce risk. However, no evaluation, concerning how efficiently the warnings are communicated and understood, has been done to date. Avalanche warnings communicate complex natural phenomena, with a variable complexity and level of uncertainty about both the future and the present. In order to manage avalanche risk successfully, it is fundamental that the warning message can be understood and translated into practice by a wide range of different user groups. Less avalanche-competent users may need simple information to decide when to stay away from avalanche terrain, while professional users may need advanced technical details in order to make their decisions. To evaluate how different modes of communication are understood, and how efficiently the informational content is communicated, we designed and implemented a web-based user survey. The modes of presentation were based on the Varsom.no 2017-version (Varsom.no being the national portal for natural hazards warnings in Norway). We first asked a panel of experts from NAWS to answer the survey, and used their answers to establish the indented comprehension of the avalanche warning. We thereafter recruited over 200 recreational users, and compared their answers to those of the experts for the different modes of communication. Our empirical analyses suggest that most users find the warning service to be useful and well suited for their needs. However, the effectiveness of a warnings seems to be influenced by the competency of the user and the complexity of the scenarios. We discuss the findings and make recommendations on how to improve communication of avalanche warnings.

Core qualities of an educational program to reduce fears and beliefs of GPs about low back pain: Results of a GPs, experts and literature survey

2020 ◽  
pp. 1-13
Author(s):  
Julia Facione ◽  
Camille Daste ◽  
Claire Verdaguer ◽  
Éric Lapeyre ◽  
Marie-Martine Lefèvre-Colau ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Educational Program ◽  
Controlled Trial ◽  
Evidence Based ◽  
Low Back ◽  
Web Based ◽  
The Core ◽  
Wide Range ◽  
Data Source

BACKGROUND: Despite the fact that non-specific low back pain (LBP) is a frequent symptom, its management remains suboptimal in primary care. A plausible reason is the persistence of erroneous fears and beliefs among general practitioners (GPs). OBJECTIVE: We aimed to determine the core qualities an educational program should have to reduce erroneous fears and beliefs about LBP among GPs. METHODS: We used a two step-approach. In the first step, meaningful qualities were collected using comprehensive data source triangulation from GPs, experts and literature. In the second step, qualities were extracted by three independent investigators in a standardized manner using the Template for Intervention Description and Replication checklist. RESULTS: Qualities were collected from 8 GPs, 24 experts and 15 articles. Extraction revealed a wide range of qualities depending on participants’ background and literature. After consensus between investigators, the most meaningful qualities included evidence-based messages and web-based interventions (videos and classes) delivered by a multidisciplinary panel of experts. We found no systematic trend for when and how much, and how to tailor the intervention. CONCLUSIONS: Data source triangulation revealed that the core qualities of an educational program targeting fears and beliefs about LBP among GPs should include evidence-based information, web-based interventions and a multidisciplinary panel of experts. Our findings will help us to design a provisional targeted educational intervention. This will be further assessed in a mixed-method feasibility study and then in a randomized controlled trial.

Understanding Limited Use of Amplification in Infants and Children Who Are Hard of Hearing

2015 ◽  
Vol 25 (1) ◽  
pp. 15-23 ◽  
Author(s):  
Ryan W. McCreery ◽  
Elizabeth A. Walker ◽  
Meredith Spratford
Keyword(s):  
Hard Of Hearing ◽  
Hearing Aid ◽  
Management Strategies ◽  
Infants And Children ◽  
Future Research ◽  
Research Needs ◽  
Case Examples ◽  
Hearing Aid Use ◽  
Wide Range ◽  
In Infants And Children

The effectiveness of amplification for infants and children can be mediated by how much the child uses the device. Existing research suggests that establishing hearing aid use can be challenging. A wide range of factors can influence hearing aid use in children, including the child's age, degree of hearing loss, and socioeconomic status. Audiological interventions, including using validated prescriptive approaches and verification, performing on-going training and orientation, and communicating with caregivers about hearing aid use can also increase hearing aid use by infants and children. Case examples are used to highlight the factors that influence hearing aid use. Potential management strategies and future research needs are also discussed.

Investigating the Efficacy and Cost-Effectiveness of a Web-based Self-help Program for People With Adjustment Problems After an Accident (SelFIT): Protocol for a Randomized Controlled Trial (Preprint)

2020 ◽  
Author(s):  
Julia Hegy ◽  
Noemi Anja Brog ◽  
Thomas Berger ◽  
Hansjoerg Znoj
Keyword(s):  
Health Care ◽  
Psychological Distress ◽  
Cost Effectiveness ◽  
Well Being ◽  
User Friendliness ◽  
Adjustment Problems ◽  
Health Care Consumption ◽  
Web Based ◽  
Self Help ◽  
Wide Range

BACKGROUND Accidents and the resulting injuries are one of the world’s biggest health care issues often causing long-term effects on psychological and physical health. With regard to psychological consequences, accidents can cause a wide range of burdens including adjustment problems. Although adjustment problems are among the most frequent mental health problems, there are few specific interventions available. The newly developed program SelFIT aims to remedy this situation by offering a low-threshold web-based self-help intervention for psychological distress after an accident. OBJECTIVE The overall aim is to evaluate the efficacy and cost-effectiveness of the SelFIT program plus care as usual (CAU) compared to only care as usual. Furthermore, the program’s user friendliness, acceptance and adherence are assessed. We expect that the use of SelFIT is associated with a greater reduction in psychological distress, greater improvement in mental and physical well-being, and greater cost-effectiveness compared to CAU. METHODS Adults (n=240) showing adjustment problems due to an accident they experienced between 2 weeks and 2 years before entering the study will be randomized. Participants in the intervention group receive direct access to SelFIT. The control group receives access to the program after 12 weeks. There are 6 measurement points for both groups (baseline as well as after 4, 8, 12, 24 and 36 weeks). The main outcome is a reduction in anxiety, depression and stress symptoms that indicate adjustment problems. Secondary outcomes include well-being, optimism, embitterment, self-esteem, self-efficacy, emotion regulation, pain, costs of health care consumption and productivity loss as well as the program’s adherence, acceptance and user-friendliness. RESULTS Recruitment started in December 2019 and is ongoing. CONCLUSIONS To the best of our knowledge, this is the first study examining a web-based self-help program designed to treat adjustment problems resulting from an accident. If effective, the program could complement the still limited offer of secondary and tertiary psychological prevention after an accident. CLINICALTRIAL ClinicalTrials.gov NCT03785912; https://clinicaltrials.gov/ct2/show/NCT03785912?cond=NCT03785912&draw=2&rank=1

Design and Development of a Web-based Delirium Preventive Application for Long-term Care Facilities: A Methodological Study (Preprint)

2020 ◽  
Author(s):  
Kyoung Ja Moon ◽  
Chang-Sik Son ◽  
Jong-Ha Lee ◽  
Mina Park
Keyword(s):  
Risk Factors ◽  
Long Term Care ◽  
Cloud System ◽  
Evidence Based ◽  
Methodological Study ◽  
Term Care ◽  
Web Based ◽  
Care Facilities ◽  
Delirium Prevention

BACKGROUND Long-term care facilities demonstrate low levels of knowledge and care for patients with delirium and are often not properly equipped with an electronic medical record system, thereby hindering systematic approaches to delirium monitoring. OBJECTIVE This study aims to develop a web-based delirium preventive application (app), with an integrated predictive model, for long-term care (LTC) facilities using artificial intelligence (AI). METHODS This methodological study was conducted to develop an app and link it with the Amazon cloud system. The app was developed based on an evidence-based literature review and the validity of the AI prediction model algorithm. Participants comprised 206 persons admitted to LTC facilities. The app was developed in 5 phases. First, through a review of evidence-based literature, risk factors for predicting delirium and non-pharmaceutical contents for preventive intervention were identified. Second, the app, consisting of several screens, was designed; this involved providing basic information, predicting the onset of delirium according to risk factors, assessing delirium, and intervening for prevention. Third, based on the existing data, predictive analysis was performed, and the algorithm developed through this was calculated at the site linked to the web through the Amazon cloud system and sent back to the app. Fourth, a pilot test using the developed app was conducted with 33 patients. Fifth, the app was finalized. RESULTS We developed the Web_DeliPREVENT_4LCF for patients of LTC facilities. This app provides information on delirium, inputs risk factors, predicts and informs the degree of delirium risk, and enables delirium measurement or delirium prevention interventions to be immediately implemented with a verified tool. CONCLUSIONS This web-based application is evidence-based and offers easy mobilization and care to patients with delirium in LTC facilities. Therefore, the use of this app improves the unrecognized of delirium and predicts the degree of delirium risk, thereby helping initiatives for delirium prevention and providing interventions. This would ultimately improve patient safety and quality of care. CLINICALTRIAL none

scholarly journals Epidemiological modeling in StochSS Live!

2021 ◽  
Author(s):  
Richard Jiang ◽  
Bruno Jacob ◽  
Matthew Geiger ◽  
Sean Matthew ◽  
Bryan Rumsey ◽  
...  
Keyword(s):  
Stochastic Model ◽  
Epidemiological Model ◽  
Supplementary Information ◽  
Supplementary Data ◽  
Web Based ◽  
Epidemiological Modeling ◽  
Modeling Simulation ◽  
Wide Range ◽  
Biochemical Systems

Abstract Summary We present StochSS Live!, a web-based service for modeling, simulation and analysis of a wide range of mathematical, biological and biochemical systems. Using an epidemiological model of COVID-19, we demonstrate the power of StochSS Live! to enable researchers to quickly develop a deterministic or a discrete stochastic model, infer its parameters and analyze the results. Availability and implementation StochSS Live! is freely available at https://live.stochss.org/ Supplementary information Supplementary data are available at Bioinformatics online.

scholarly journals Healthcare Providers’ Perceptions of Challenges with Frequent Users of Emergency Department Care in Switzerland: A Qualitative Study

2021 ◽  
Vol 58 ◽  
pp. 004695802110281
Author(s):  
Patrick Bodenmann ◽  
Miriam Kasztura ◽  
Madison Graells ◽  
Elodie Schmutz ◽  
Oriane Chastonay ◽  
...  
Keyword(s):  
Online Survey ◽  
Emergency Services ◽  
Healthcare Providers ◽  
Negative Consequences ◽  
Emergency Department Care ◽  
Frequent Users ◽  
Complex Needs ◽  
Wide Range ◽  
Ed Overcrowding ◽  
Ed Visits

Frequent users of emergency departments (FUED; ≥ 5 ED visits/year) commonly cumulate medical, social, and substance use problems requiring complex and sustained care coordination often unavailable in ED. This study aimed to explore ED healthcare providers’ challenges related to FUED care to gain insight into the support and resources required to address FUED complex needs. An online survey was sent to all general adult emergency services within Switzerland (N = 106). Participants were asked to indicate the extent to which they perceived that FUED represented a problem and to describe the main challenges encountered. In total, 208 physicians and nurses from 75 EDs (70.7%) completed the survey. Among the 208 participants, 134 (64%) reported that FUED represented a challenge and 133 described 1 to 5 challenges encountered. A conventional content analysis yielded 4 main categories of perceived challenges. Negative consequences in the ED secondary to FUED’s presence (eg, ED overcrowding, staff helplessness, and fatigue) was the most frequently reported challenge, followed by challenges related to FUEDs’ characteristics (eg, mental health and social problems) leading to healthcare complexity. The third most frequently encountered challenge was related to the ED inappropriateness and inefficiency to address FUEDs’ needs. Finally, challenges related to the lack of FUED healthcare network were the least often mentioned. ED healthcare providers experience a wide range of challenges related to FUED care. These findings suggest that currently EDs nor their staff are equipped to address FUEDs’ complex needs.

Adapting an Evidence-Based Early Childhood Tier 2 Social-Emotional Learning Intervention for Web-Based Delivery

2021 ◽  
pp. 004723952110160
Author(s):  
Kristen L. Granger ◽  
Maureen A. Conroy ◽  
Kevin S. Sutherland ◽  
Edward G. Feil ◽  
Jessica Wright ◽  
...  
Keyword(s):  
Early Childhood ◽  
Intervention Program ◽  
Phase 1 ◽  
Lessons Learned ◽  
Study Phase ◽  
Evidence Based ◽  
Tier 2 ◽  
Web Based ◽  
Testing Phase ◽  
Panel Review

The purpose of this article is to describe the adaptation process of an evidence-based early childhood Tier-2 intervention program, BEST in CLASS-Prekindergarten, from a face-to-face format to a web-based delivery format called BEST in CLASS-Web. We describe the three-phase iterative development process used to adapt the parent program for delivery via the web. Activities in these phases included focus groups, interviews, an expert panel review, alpha and beta testing (Phase 1), feasibility testing (Phase 2), and a pilot promise study (Phase 3). Each phase included a series of refinements and improvements to materials based on data and stakeholder feedback. Lessons learned and implications for developing and implementing professional development services via online platforms are discussed.

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