Co-Production Performance Evaluation in Healthcare. A Systematic Review of Methods, Tools and Metrics

Co-produced practices and publications in the healthcare sector are gaining momentum, since they can be a useful tool in addressing the sustainability and resilience challenges of health systems. However, the investigation of positive and, mainly, negative outcomes is still confused and fragmented, and above all, a comprehensive knowledge of the metrics used to assess these outcomes is lacking. To fill this gap, this study aims to systematically review the extant literature to map the methods, tools and metrics used to empirically evaluate co-production in health services. The search took place in six databases: Scopus, Web of Science, Psych INFO, PubMed, Cochrane and CINAHL. A total of 2311 articles were screened and 203 articles were included in the analysis, according to PRISMA guidelines. Findings show that outcomes are mainly investigated through qualitative methods and from the lay actor or provider perspective. Moreover, the detailed categorisation of the quantitative measures found offers a multidimensional performance measurement system and highlights the impact areas where research is needed to develop and test new measures. Findings should also promote improvements in empirical data collection on the multiple faceted co-produced activities and spur the consciousness of the adoption of sustainable co-productive initiatives.

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Data Quality and Cost-Effectiveness Analyses of Electronic and Paper-Based Interviewer-Administered Public Health Surveys: Protocol for a Systematic Review (Preprint)

10.2196/preprints.10678 ◽

2018 ◽

Author(s):

Atinkut Alamirrew Zeleke ◽

Tolga Naziyok ◽

Fleur Fritz ◽

Rainer Röhrig

Keyword(s):

Public Health ◽

Systematic Review ◽

Cost Effectiveness ◽

Data Collection ◽

Data Quality ◽

Cost Reduction ◽

Health Surveys ◽

Web Of Science ◽

Population Level ◽

The Impact

BACKGROUND Population-level survey is an essential standard method used in public health research to quantify sociodemographic events and support public health policy development and intervention designs with evidence. Although all steps in the survey can contribute to the data quality parameters, data collection mechanisms seem the most determinant, as they can avoid mistakes before they happen. The use of electronic devices such as smartphones and tablet computers improve the quality and cost-effectiveness of public health surveys. However, there is lack of systematically analyzed evidence to show the potential impact on data quality and cost reduction of electronic-based data collection tools in interviewer-administered surveys. OBJECTIVE This systematic review aims to evaluate the impact of interviewer-administered electronic device data collection methods concerning data quality and cost reduction in population-level surveys compared with the traditional paper-based methods. METHODS We will conduct a systematic search on Medical Literature Analysis and Retrieval System Online, PubMed, CINAHL, PsycINFO, Global Health, Trip, ISI Web of Science, and Cochrane Library for studies from 2007 to 2018 to identify relevant studies. The review will include randomized and nonrandomized studies that examine data quality and cost reduction outcomes. Moreover, usability, user experience, and usage parameters from the same study will be summarized. Two independent authors will screen the title and abstract. A third author will mediate in cases of disagreement. If the studies are considered to be combinable with minimal heterogeneity, we will perform a meta-analysis. RESULTS The preliminary search in PubMed and Web of Science showed 1491 and 979 resulting hits of articles, respectively. The review protocol is registered in the International Prospective Register of Systematic Reviews (CRD42018092259). We anticipate January 30, 2019, to be the finishing date. CONCLUSIONS This systematic review will inform policymakers, investors, researchers, and technologists about the impact of an electronic-based data collection system on data quality, work efficiency, and cost reduction. CLINICALTRIAL PROSPERO CRD42018092259; http://www.crd.york.ac.uk/PROSPERO/display_record.php?ID= CRD42018092259 INTERNATIONAL REGISTERED REPORT PRR1-10.2196/10678

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The Clinical Utility of Virtual Reality in Neurorehabilitation: A Systematic Review

Journal of Central Nervous System Disease ◽

10.1177/1179573518813541 ◽

2018 ◽

Vol 10 ◽

pp. 117957351881354 ◽

Cited By ~ 25

Author(s):

Thais Massetti ◽

Talita Dias da Silva ◽

Tânia Brusque Crocetta ◽

Regiani Guarnieri ◽

Bruna Leal de Freitas ◽

...

Keyword(s):

Systematic Review ◽

Virtual Reality ◽

Virtual Environments ◽

Neurological Disorders ◽

Clinical Utility ◽

Spinal Cord Injuries ◽

Web Of Science ◽

The Past ◽

Meta Analyses ◽

The Impact

Background: Virtual reality (VR) experiences (through games and virtual environments) are increasingly being used in physical, cognitive, and psychological interventions. However, the impact of VR as an approach to rehabilitation is not fully understood, and its advantages over traditional rehabilitation techniques are yet to be established. Method: We present a systematic review which was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). During February and March of 2018, we conducted searches on PubMed (Medline), Virtual Health Library Search Portal databases (BVS), Web of Science (WOS), and Embase for all VR-related publications in the past 4 years (2015, 2016, 2017, and 2018). The keywords used in the search were “neurorehabilitation” AND “Virtual Reality” AND “devices.” Results: We summarize the literature which highlights that a range of effective VR approaches are available. Studies identified were conducted with poststroke patients, patients with cerebral palsy, spinal cord injuries, and other pathologies. Healthy populations have been used in the development and testing of VR approaches meant to be used in the future by people with neurological disorders. A range of benefits were associated with VR interventions, including improvement in motor functions, greater community participation, and improved psychological and cognitive function. Conclusions: The results from this review provide support for the use of VR as part of a neurorehabilitation program in maximizing recovery.

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Pregnancy and Breastfeeding During COVID-19 Pandemic: A Systematic Review of Published Pregnancy Cases

Frontiers in Public Health ◽

10.3389/fpubh.2020.558144 ◽

2020 ◽

Vol 8 ◽

Author(s):

Carina Rodrigues ◽

Inês Baía ◽

Rosa Domingues ◽

Henrique Barros

Keyword(s):

Systematic Review ◽

Adverse Effects ◽

Pregnant Women ◽

Pregnancy Outcomes ◽

Web Of Science ◽

Study Quality ◽

Neonatal Deaths ◽

Live Births ◽

Milk Samples ◽

The Impact

Background: The COVID-19 pandemic is an emerging concern regarding the potential adverse effects during pregnancy. This study reviews knowledge on the impact of COVID-19 on pregnancy and describes the outcome of published cases of pregnant women diagnosed with COVID-19.Methods: Searches were conducted in PubMed®, Scopus®, Web of Science®, and MedRxiv® up to 26th June 2020, using PRISMA standards, to identify original published studies describing pregnant women at any gestational age diagnosed COVID-19. There were no date or language restrictions on the search. All identified studies were included irrespective of assumptions on study quality.Results: We identified 161 original studies reporting 3,985 cases of pregnant women with COVID-19 (1,007 discharged while pregnant). The 2,059 published cases with pregnancy outcomes resulted in 42 abortions, 21 stillbirths, and 2,015 live births. Preterm birth occurred in 23% of cases. Around 6% of pregnant women required admission to an intensive care unit and 28 died. There were 10 neonatal deaths. From the 163 cases with amniotic fluid, placenta, and/or cord blood analyzed for the SARS-CoV-2 virus, 10 were positive. Sixty-one newborns were positive for SARS-CoV-2. Four breast milk samples from 92 cases showed evidence of SARS-CoV-2.Conclusion: Emerging evidence suggests that vertical transmission is possible, however, there is still a limited number of reported cases with intrapartum samples. Information, counseling and adequate monitoring are essential to prevent and manage adverse effects of SARS-CoV-2 infection during pregnancy.

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Clinical manifestations and perinatal outcomes of pregnant women with COVID-19: a systematic review and meta-analysis

Scientific Reports ◽

10.1038/s41598-020-75096-4 ◽

2020 ◽

Vol 10 (1) ◽

Cited By ~ 1

Author(s):

Jeong Yee ◽

Woorim Kim ◽

Ji Min Han ◽

Ha Young Yoon ◽

Nari Lee ◽

...

Keyword(s):

Systematic Review ◽

Pregnant Women ◽

Fetal Death ◽

Web Of Science ◽

Meta Analysis ◽

Clinical Manifestations ◽

Perinatal Outcomes ◽

Current Review ◽

The Mean ◽

The Impact

Abstract This systematic review and meta-analysis aimed to evaluate the impact of COVID-19 on pregnant women. We searched for qualified studies in PubMed, Embase, and Web of Science. The clinical characteristics of pregnant women with COVID-19 and their infants were reported as means and proportions with 95% confidence interval. Eleven studies involving with 9032 pregnant women with COVID-19 and 338 infants were included in the meta-analysis. Pregnant women with COVID-19 have relatively mild symptoms. However, abnormal proportions of laboratory parameters were similar or even increased, compared to general population. Around 30% of pregnant women with COVID-19 experienced preterm delivery, whereas the mean birth weight was 2855.9 g. Fetal death and detection of SARS-CoV-2 were observed in about 2%, whereas neonatal death was found to be 0.4%. In conclusion, the current review will serve as an ideal basis for future considerations in the treatment and management of COVID-19 in pregnant women.

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Impact of traditional bonesetters on contemporary fracture care in Low and Middle Income Countries (LMICs): a systematic review

10.21203/rs.2.15579/v1 ◽

2019 ◽

Author(s):

Ndubuisi Onyemaechi ◽

William N.A. Menson ◽

Xan Goodman ◽

Samantha Slinkard ◽

Obinna E Onwujekwe ◽

...

Keyword(s):

Systematic Review ◽

Retrospective Studies ◽

Web Of Science ◽

Clinical Effects ◽

Middle Income ◽

Fracture Care ◽

Middle Income Countries ◽

Meta Analyses ◽

The Impact ◽

Low And Middle Income

Abstract Background: The review aimed at systematically examining the evidence in articles that assess the clinical effects and impact of traditional bonesetters on contemporary fracture care in Low and Middle Income Countries (LMICs).Methods: A systematic review was conducted. Articles were identified by database searching ((PubMed, Embase, ScienceDirect, SCOPUS, and Web of Science). Searching, selecting and reporting were conducted according to the PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) Statement. The key words that were used in search for literature were: “Bonesetter”, “fracture healer” and “traditional bone setting”. Publications included for review were original articles, set in an LMIC and directly talked about the role and/or impact of traditional bonesetters in providing fracture care. Papers that focused on Low and Middle Income (LMIC) settings were reviewed.Results: A total of 176 papers were screened for eligibility and 15 studies were finally included. Nine were prospective studies, while 6 were retrospective studies. Most of the studies focused on clinical impacts of bone setter intervention. The evidence from the publications show that the main clinical effects of traditional bonesetters had been deleterious, but they had the potential to contribute positively when trained.Conclusion: Few well designed studies are available that assessed the impact of traditional bonesetters. Reported cases and reviews indicate their impact to be deleterious. However, the potential exist that when trained, these deleterious impact can be reduced through training for traditional bonesetters who contribute to fracture care in many LMICs.

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Remote home monitoring (virtual wards) during the COVID-19 pandemic: a living systematic review

10.1101/2020.10.07.20208587 ◽

2020 ◽

Cited By ~ 1

Author(s):

Cecilia Vindrola-Padros ◽

Kelly E Singh ◽

Manbinder S Sidhu ◽

Theo Georghiou ◽

Chris Sherlaw-Johnson ◽

...

Keyword(s):

Systematic Review ◽

Patient Safety ◽

Outcome Measures ◽

Secondary Care ◽

Meta Analysis ◽

Eligible Patient ◽

Home Monitoring ◽

Healthcare Sector ◽

Future Research ◽

The Impact

ABSTRACTObjectivesThe aim of this review was to analyse the implementation and impact of remote home monitoring models (virtual wards) during COVID-19, identifying their main components, processes of implementation, target patient populations, impact on outcomes, costs and lessons learnt. The review will be kept ‘live’ through regular updates.DesignThe review was designed as a living systematic review to capture a rapidly evolving evidence base. We used the Preferred Reporting Items for Systematic Reviews and Meta- Analysis (PRISMA) statement.SettingThe review included remote home monitoring models led by primary and secondary care across seven countries.Participants17 examples of remote home monitoring models were included in the review.Main outcome measuresImpact of remote home monitoring on virtual length of stay, escalation, Emergency department attendance/reattendance, admission/readmission and mortality.ResultsThe primary aim of the remote home monitoring models was the early identification of deterioration for patients self-managing COVID-19 symptoms at home. Most models were led by secondary care. Broad criteria for the eligible patient population were used and confirmation of COVID-19 was not required (in most cases). Monitoring was carried via online platforms, paper-based systems with telephone calls or (less frequently) through wearable sensors. We could not reach conclusions regarding patient safety and the identification of early deterioration due to lack of standardised reporting across articles and missing data. None of the articles reported any form of economic analysis, beyond how the resources were used.ConclusionsThe review pointed to variability in the implementation of the models, in relation to healthcare sector, monitoring approach and selected outcome measures. Lack of standardisation on reporting prevented conclusions on the impact of remote home monitoring on patient safety or early escalation during COVID-19. Future research should focus on staff and patient experiences of care and potential inequalities in patients’ access to these models. Attention needs to be paid to the processes used to implement these models, the evaluation of their impact on patient outcomes through the use of comparators, the use of risk-stratification tools, and cost-effectiveness of the models and their sustainability.Protocol registrationThe review protocol was published on PROSPERO (CRD: 42020202888).

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Body mass index and outcomes of patients with laparoscopic adrenalectomy: a systematic review and meta-analysis protocol

BMJ Open ◽

10.1136/bmjopen-2018-028579 ◽

2019 ◽

Vol 9 (6) ◽

pp. e028579

Author(s):

Celestin Danwang ◽

Valirie Ndip Agbor ◽

Jean Joel Bigna

Keyword(s):

Systematic Review ◽

Body Mass Index ◽

Body Mass ◽

Laparoscopic Adrenalectomy ◽

Web Of Science ◽

Citation Index ◽

Meta Analysis ◽

Russian Science Citation Index ◽

Statistical Heterogeneity ◽

The Impact

IntroductionRecent advances in the field of medical imaging and minimal invasive surgery have improved the diagnosis and treatment of adrenal incidentalomas. Recent studies suggest increased morbidity and mortality among patients with obesity following laparoscopic adrenalectomy compared with patients without obesity. However, this claim remains to be ascertained. This review seeks to assess the outcome of patients with and without obesity after adrenalectomy.Methods and designWe will include cohort studies, case-control studies, cross-sectional studies and case series with more than 30 participants. EMBASE, Medline and Web of Science (Web of Science Core Collection, Current Contents Connect, KCI-Korean Journal Database, SciELO Citation Index, Russian Science Citation Index) will be searched for relevant abstracts of studies published between 1 January 2000 and 31 May 2019, without language restriction. The review will be reported according to the Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines. After screening of abstracts, study selection, data extraction and methodological quality assessment, we shall assess the studies individually for clinical and statistical heterogeneity. Random-effect meta-analysis will be used to pool studies judged to be clinically homogenous. The Harbord’s test and visual inspection of funnel plots will be used to assess publication bias. Results will be presented by country and region.Ethics and disseminationSince primary data are not collected in this study, ethical approval is not required. This review is expected to provide relevant data on the impact of body mass index on the outcome of laparoscopic adrenalectomy. The final report will be published in a peer-reviewed journal.PROSPERO registration numberCRD42018117070.Review statusPreliminary searches.

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Impact on Dental Economics and Dental Healthcare Utilization in COVID-19: An Exploratory Study

Journal of Advanced Oral Research ◽

10.1177/2320206820941365 ◽

2020 ◽

Vol 11 (2) ◽

pp. 128-136

Author(s):

Naiya Patel

Keyword(s):

Economic Impact ◽

English Language ◽

Web Of Science ◽

Grey Literature ◽

Healthcare Services ◽

Flow Diagram ◽

Healthcare Sector ◽

Research Review ◽

Exploratory Research ◽

The Impact

Aim: The current exploratory research establishes a correlation between the general unemployment rate due to COVID-19 and its effect on dental healthcare service utilization, workforce, and education attainments. Materials and methods: The conceptual model utilized in the study is the circular flow diagram explaining economy organization. The study is an exploratory research review. PRISMA guidelines are followed for the review of articles. The literature data for the current review study is obtained from Web of Science, Statista, Grey Literature like, the Federal Bank St. Louis, American Dental Association (ADA), Health Policy Institute, to justify the economic impact in the dental industry sector. The search terms employed to search for literature from the Web of Science database are “Dental” and “COVID-19.” Only research articles published in the past one year in English language are included as the final sample of literature review. Statista, Federal Bank, and ADA are utilized to take into consideration evolving economic impact data due to COVID-19. Results: Much less of research has been performed on the impact of COVID-19 on dental economics, and this study is one of the insights of projections about COVID-19 impact in the dental healthcare sector. The projected hardships of the economy during and post pandemic demand for timely measures in place. The dental regulating bodies must undertake those protocols to save the dental healthcare industry. Conclusions: Unlike other healthcare sectors, the impact of COVID-19 will disproportionately affect the dental healthcare sector for several reasons. Given dental healthcare services aid in generating nation’s revenue like any other sector, it demands urgent actions from regulating authorities.

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Patient prioritisation methods to shorten waiting times for elective surgery: a systematic review of how to improve access to surgery

10.1101/2021.02.18.21252033 ◽

2021 ◽

Author(s):

Dimuthu Rathnayake ◽

Mike Clarke ◽

Viraj Jayasinghe

Keyword(s):

Systematic Review ◽

Web Of Science ◽

Elective Surgery ◽

Waiting Times ◽

Healthcare Management ◽

Waiting List ◽

Cochrane Library ◽

Wide Range ◽

The Impact ◽

Patient Prioritisation

ABSTRACTBackgroundConcern about long waiting times for elective surgeries is not a recent phenomenon, but it has been heightened by the impact of the COVID-19 pandemic and its associated measures. One way to alleviate the problem might be to use prioritisation methods for patients on the waiting list and a wide range of research is available on such methods. However, significant variations and inconsistencies have been reported in prioritisation protocols from various specialties, institutions, and health systems. To bridge the evidence gap in existing literature, this comprehensive systematic review will synthesise global evidence on policy strategies with a unique insight to patient prioritisation methods to reduce waiting times for elective surgeries. This will provide evidence that might help with the tremendous burden of surgical disease that is now apparent in many countries because of operations that were delayed or cancelled due to the COVID-19 pandemic and inform policy for sustainable healthcare management systems.MethodsWe searched PubMed, EMBASE, SCOPUS, Web of Science, and the Cochrane Library, with our most recent searches in January 2020. Articles published after 2013 on major elective surgery lists of adult patients were eligible, but cancer and cancer-related surgeries were excluded. Both randomised and non-randomised studies were eligible and the quality of studies was assessed with ROBINS-I and CASP tools. We registered the review in PROSPERO (CRD42019158455) and reported it in accordance with the PRISMA statement.ResultsThe electronic search in five bibliographic databases yielded 7543 records (PubMed, EMBASE, SCOPUS, Web of Science, and Cochrane) and 17 eligible articles were identified in the screening. There were four quasi-experimental studies, 11 observational studies and two systematic reviews. These demonstrated moderate to low risk of bias in their research methods. Three studies tested generic approaches using common prioritisation systems for all elective surgeries in common. The other studies assessed specific prioritisation approaches for re-ordering the waiting list for a particular surgical specialty.ConclusionsExplicit prioritisation tools with a standardised scoring system based on clear evidence-based criteria are likely to reduce waiting times and improve equitable access to health care. Multiple attributes need to be considered in defining a fair prioritisation system to overcome limitations with local variations and discriminations. Collating evidence from a diverse body of research provides a single framework to improve the quality and efficiency of elective surgical care provision in a variety of health settings. Universal prioritisation tools with vertical and horizontal equity would help with re-ordering patients on waiting lists for elective surgery and reduce waiting times.

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Patient prioritisation methods to shorten waiting times for elective surgery: A systematic review of how to improve access to surgery

PLoS ONE ◽

10.1371/journal.pone.0256578 ◽

2021 ◽

Vol 16 (8) ◽

pp. e0256578

Author(s):

Dimuthu Rathnayake ◽

Mike Clarke ◽

Viraj Jayasinghe

Keyword(s):

Systematic Review ◽

Web Of Science ◽

Elective Surgery ◽

Waiting Times ◽

Healthcare Management ◽

Waiting List ◽

Cochrane Library ◽

Wide Range ◽

The Impact ◽

Patient Prioritisation

Background Concern about long waiting times for elective surgeries is not a recent phenomenon, but it has been heightened by the impact of the COVID-19 pandemic and its associated measures. One way to alleviate the problem might be to use prioritisation methods for patients on the waiting list and a wide range of research is available on such methods. However, significant variations and inconsistencies have been reported in prioritisation protocols from various specialties, institutions, and health systems. To bridge the evidence gap in existing literature, this comprehensive systematic review will synthesise global evidence on policy strategies with a unique insight to patient prioritisation methods to reduce waiting times for elective surgeries. This will provide evidence that might help with the tremendous burden of surgical disease that is now apparent in many countries because of operations that were delayed or cancelled due to the COVID-19 pandemic and inform policy for sustainable healthcare management systems. Methods We searched PubMed, EMBASE, SCOPUS, Web of Science, and the Cochrane Library, with our most recent searches in January 2020. Articles published after 2013 on major elective surgery lists of adult patients were eligible, but cancer and cancer-related surgeries were excluded. Both randomised and non-randomised studies were eligible and the quality of studies was assessed with ROBINS-I and CASP tools. We registered the review in PROSPERO (CRD42019158455) and reported it in accordance with the PRISMA statement. Results The electronic search in five bibliographic databases yielded 7543 records (PubMed, EMBASE, SCOPUS, Web of Science, and Cochrane) and 17 eligible articles were identified in the screening. There were four quasi-experimental studies, 11 observational studies and two systematic reviews. These demonstrated moderate to low risk of bias in their research methods. Three studies tested generic approaches using common prioritisation systems for all elective surgeries in common. The other studies assessed specific prioritisation approaches for re-ordering the waiting list for a particular surgical specialty. Conclusions Explicit prioritisation tools with a standardised scoring system based on clear evidence-based criteria are likely to reduce waiting times and improve equitable access to health care. Multiple attributes need to be considered in defining a fair prioritisation system to overcome limitations with local variations and discriminations. Collating evidence from a diverse body of research provides a single framework to improve the quality and efficiency of elective surgical care provision in a variety of health settings. Universal prioritisation tools with vertical and horizontal equity would help with re-ordering patients on waiting lists for elective surgery and reduce waiting times.

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