| 1. |
- Anderberg, Peter, et al.
(författare)
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A Novel Instrument for Measuring Older People's Attitudes Toward Technology (TechPH) : Development and Validation
- 2019
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Ingår i: Journal of Medical Internet Research. - : JMIR PUBLICATIONS, INC. - 1438-8871. ; 21:5
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Tidskriftsartikel (refereegranskat)abstract
- Background: The use of health technology by older people is coming increasingly in focus with the demographic changes. Health information technology is generally perceived as an important factor in enabling increased quality of life and reducing the cost of care for this group. Age-appropriate design and facilitation of technology adoption are important to ensure functionality and removal of various barriers to usage. Development of assessment tools and instruments for evaluating older persons' technology adoption and usage as well as measuring the effects of the interventions are of high priority. Both usability and acceptance of a specific technology or service are important factors in evaluating the impact of a health information technology intervention. Psychometric measures are seldom included in evaluations of health technology. However, basic attitudes and sentiments toward technology (eg, technophilia) could be argued to influence both the level of satisfaction with the technology itself as well as the perception of the health intervention outcome. Objective: The purpose of this study is to develop a reduced and refined instrument for measuring older people's attitudes and enthusiasm for technology based on relevant existing instruments for measuring technophilia A requirement of the new instrument is that it should be short and simple to make it usable for evaluation of health technology for older people. Methods: Initial items for the TechPH questionnaire were drawn from a content analysis of relevant existing technophilia measure instruments. An exploratory factor analysis was conducted in a random selection of persons aged 65 years or older (N=374) on eight initial items. The scale was reduced to six items, and the internal consistency and reliability of the scale were examined. Further validation was made by a confirmatory factor analysis (CFA). Results: The exploratory factor analysis resulted in two factors. These factors were analyzed and labeled techEnthusiasm and techAnxiety. They demonstrated relatively good internal consistency (Cronbach alpha=.72 and .68, respectively). The factors were confirmed in the CFA and showed good model fit (chi(2)(8)=21.2, chi(2)/df=2.65, comparative fit index=0.97, adjusted goodness-of-fit index=0.95, root mean square error of approximation=0.067, standardized root mean square residual=0.036). Conclusions: The construed TechPH score showed expected relations to external real-world criteria, and the two factors showed interesting internal relations. Different technophilia personality traits distinguish clusters with different behaviors of adaptation as well as usage of new technology. Whether there is an independent association with the TechPH score against outcomes in health technology projects needs to be shown in further studies. The instrument must also be validated in different contexts, such as other countries.
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| 2. |
- Eivazzadeh, Shahryar, 1975-, et al.
(författare)
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Design of a Semi-Automated and Continuous Evaluation System : Customized for Application in e-Health
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Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
- Background and ObjectivesSurvey-based evaluation of a system, such as measuring user’s satisfaction or patient-reported outcomes, entails a set of burdens that limits the feasibility, frequency, extendability, and continuity of the evaluation. Automating the evaluation process, that is reducing the burden of evaluators in questionnaire curation or minimizing the need for explicit user attention when collecting their attitudes, can make the evaluation more feasible, repeatable, extendible, continuous, and even flexible for improvement. An automated evaluation process can be enhanced to include features, such as the ability to handle heterogeneity in evaluation cases. Here, we represent the design of a system that makes it possible to have a semi-automated evaluation system. The design is presented and partially implemented in the context of health information systems, but it can be applied to other contexts of information system usages as well.MethodThe system was divided into four components. We followed a design research methodology to design the system, where each component reached a certain level of maturity. Already implemented and validated methods from previous studies were embedded within components, while they were extended with improved automation proposals or new features.ResultsA system was designed, comprised of four major components: Evaluation Aspects Elicitation, User Survey, Benchmark Path Model, and Alternative Metrics Replacement. All components have the essential maturity of identification of the problem, identification of solution objectives, and the overall design. In the overall design, the primary flow, process-entities, data-entities, and events for each component are identified and illustrated. Parts of some components have been already verified and demonstrated in real-world cases.ConclusionA system can be developed to minimize human burden, both for the evaluators and respondants, in survey-based evaluation. This system automates finding items to evaluate, creating questionnaire based on those items, surveying the users' attitude about those items, modeling the relations between the evaluation items, and incrementally changing the model to rely on automatically collected metrics, usually implicit indicators, collected from the users, instead of requiring their explicit expression of their attitudes. The system provides the possibility of minimal human burden, frequent repetition, continuity and real-time reporting, incremental upgrades regarding environmental changes, proper handling of heterogeneity, and a higher degree of objectivity.
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| 3. |
- Eivazzadeh, Shahryar, 1975-, et al.
(författare)
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Designing with Priorities and Thresholds for Health Care Heterogeneity : The Approach of Constructing Parametric Ontology
- 2015
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Ingår i: Proceedings of the International Conference on Engineering Design (ICED 15). - : The Design Society. - 9781904670650 ; , s. 277-284
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Konferensbidrag (refereegranskat)abstract
- Designing systems working in health care needs complying with the heterogeneous, overlapping, non-overlapping, competing, or even contradicting requirements expressed by the various actors of the health care complex environment, including regulatory bodies. The unification method introduced in this paper, utilized ontological struc- tures to unify heterogeneous requirements in different levels of ab- straction. Also the weighting and threshold algorithms defined upon the ontology structure allows to both prioritize the requirements and align design resources upon that priority, at the same time to enforce regulatory requirements in an easy, clear and integrated way and reject designs which cannot comply with them. Application of the method introduced in this paper is not limited to health care, but it might be applied in design for any heterogeneous environment.
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| 4. |
- Eivazzadeh, Shahryar, 1975-, et al.
(författare)
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Ethical Challenges of Evaluating Health Information Systems
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Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
- BackgroundEvaluating and researching health information systems are interventions of their kind and might lead to ethical complexities and challenges. Most of those challenges are inherited from the more general fields of research and evaluation, health studies, and information systems studies. Beyond those challenges, this field has its particular traits, regarding the involved stakeholders, required values or qualities, or the process which can raise field-specific or context-specific ethical challenges.ObjectivesThis paper reports and discusses some of the challenges of evaluating and researching health information systems by taking a systematic approach in finding, postulating, and analyzing them.MethodThrough a scoping review, a set of ethical challenges, regarding the evaluation and research of health information systems, were extracted. From the same set of articles, the acting entities, including stakeholders and artefacts, were identified. From a sample of seven cases of health information systems, a set of demanded impact qualities were extracted. From the literature, the evaluation stages were elicited. The acting entities, required qualities, and the evaluation stages were combined to create a three-dimensional space. The space contained the ethical challenges extracted from the scoping review and helped to postulate more items.ResultsThe final list of identified items contains 20 possible ethical challenges that can be caused or raised by evaluating or researching health information systems and technologies. The ethical challenges are discussed, based on their probable stage of occurrence. The three-dimensional space and the method of populating it is proposed as an effective method in similar cases of discovering ethical challenges.ConclusionEvaluating or researching health information systems can raise ethical challenges, that we have identified 20 of them in this article. All the challenges were discussed, such as the actual value of evaluation, breach of privacy, risks for safety, problems with usability and accessibility, conflict of interests, problems with the informed consent, and miscommunication. The novel approach for elicitation of the ethical challenges introduced in this article might be applied in other similar studies.
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| 5. |
- Eivazzadeh, Shahryar, 1975-
(författare)
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Evaluating Success Factors of Health Information Systems
- 2019
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Health information systems are our technological response to the growing demand for health care. However, their success in their mission can be challenging due to the complexity of evaluating technological interventions in health care. In the series of studies compiled in this dissertation, we looked at the evaluation of these systems. We focused on the evaluation of factors that lead to success, where success is indicated by user satisfaction and can be induced by both intervention-specific and individual-specific factors.Study 1 developed a method, called UVON, to elicit and organise the user-demanded qualities in the outcomes of the health information system intervention. Through the application of the UVON method in the FI-STAR project, an EU project which developed and deployed seven e-health applications in seven member countries, ten categories of quality and their subcategories were identified. These qualities formed two questionnaires, specific to the patient and health professional users. Through the questionnaires, the patients and health-professionals users evaluated and graded both the occurrence of those demanded qualities in the project outcomes and their general satisfaction.Study 2 analysed the survey results to find out which of those ten qualities have the highest impact on satisfaction or can predict it better. Two partial least squares structural equation modelling (PLS-SEM) models were constructed, for the patient and health professionals, based on the Unified eValuation using ONtology (UVON) and survey outputs. The models showed that effectiveness is an important quality in creating satisfaction for both user groups. Besides, affordability for the health professionals and efficiency plus safety for the patients were the most influential. A satisfaction index is also introduced for simple and fast inferring of the changes in the outcome qualities.Study 5 recruited outputs and learnings from studies 1 and 2 to design a system that partially automates the process of evaluating success factors in health information systems, making it continuous and real-time, and replacing hard-to-run surveys with automatically captured indicators and analytics.Study 3 focused on individual-specific factors in using health information systems, particularly the technophilia personality trait. A short six-items instrument, called TechPH, was designed to measure technophilia in users, tuned for older users. The study recruited empirical data from the Swedish National Study on Aging and Care (SNAC) project. Two factors, labelled techAnxiety and techEnthusiams, are identified by the factor analysis method. A TechPH score was introduced as a scalar measurement of technophilia.Study 4 elicited and discussed the ethical challenges of evaluating and researching health information systems. Both a scoping review and a novel systematic postulation approach were recruited to identify twenty ethical challenges. The identified ethical challenges were discussed and mapped into a three-dimensional space of evaluation stages, demanded qualities, and major involving entities (stakeholder and artefacts), which fosters further postulation of ethical challenges.
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| 6. |
- Eivazzadeh, Shahryar, 1975-, et al.
(författare)
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Most Influential Qualities in Creating Satisfaction Among the Users of Health Information Systems : Study in Seven European Union Countries
- 2018
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Ingår i: JMIR Medical Informatics. - : JMIR Publications. - 2291-9694. ; 6:4
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Tidskriftsartikel (refereegranskat)abstract
- Background:Several models suggest how the qualities of a product or service influence user satisfaction. Models, such as the Customer Satisfaction Index (CSI), Technology Acceptance Model (TAM), and Delone and McLean Information Systems Success (D&M IS), demonstrate those relations and have been used in the context of health information systems.Objective:We want to investigate which qualities foster greater satisfaction among patient and professional users. In addition, we are interested in knowing to what extent improvement in those qualities can explain user satisfaction and if this makes user satisfaction a proxy indicator of those qualities.Methods:The Unified eValuation using ONtology (UVON) method was utilised to construct an ontology of the required qualities for seven e-health applications being developed in the FI-STAR project, a European Union (EU) project in e-health. The e-health applications were deployed across seven EU countries. The ontology included and unified the required qualities of those systems together with the aspects suggested by the Model for ASsessment of Telemedicine applications (MAST) evaluation framework. Two similar questionnaires, for 87 patient users and 31 health professional users, were elicited from the ontology. In the questionnaires, user was asked if the system has improved the specified qualities and if the user was satisfied with the system. The results were analysed using Kendall correlation coefficients matrices, incorporating the quality and satisfaction aspects. For the next step, two Partial Least Squares Structural Equation Modelling (PLS-SEM) path models were developed using the quality and satisfaction measure variables and the latent construct variables that were suggested by the UVON method.Results:Most of the quality aspects grouped by the UVON method are highly correlated. Strong correlations in each group suggest that the grouped qualities can be measures which reflect a latent quality construct. The PLS-SEM path analysis for the patients reveals that the effectiveness, safety, and efficiency of treatment provided by the system are the most influential qualities in achieving and predicting user satisfaction. For the professional users, effectiveness and affordability are the most influential. The parameters of the PLS-SEM that are calculated allow for the measurement of a user satisfaction index similar to CSI for similar health information systems.Conclusions:For both patients and professionals, the effectiveness of systems highly contributes to their satisfaction. Patients care about improvements in safety and efficiency, while professionals care about improvements in the affordability of treatments with health information systems. User satisfaction is reflected more in the users' evaluation of system output and fulfilment of expectations, but slightly less in how far the system is from ideal. Investigating satisfaction scores can be a simple, fast way to infer if the system has improved the abovementioned qualities in treatment and care.
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| 7. |
- Moraes, Ana Luiza Dallora, et al.
(författare)
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Machine learning and microsimulation techniques on the prognosis of dementia : A systematic literature review
- 2017
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Ingår i: PLOS ONE. - : Public Library of Science. - 1932-6203. ; 12:6
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Tidskriftsartikel (refereegranskat)abstract
- Background Dementia is a complex disorder characterized by poor outcomes for the patients and high costs of care. After decades of research little is known about its mechanisms. Having prognostic estimates about dementia can help researchers, patients and public entities in dealing with this disorder. Thus, health data, machine learning and microsimulation techniques could be employed in developing prognostic estimates for dementia. Objective The goal of this paper is to present evidence on the state of the art of studies investigating and the prognosis of dementia using machine learning and microsimulation techniques. Method To achieve our goal we carried out a systematic literature review, in which three large databases -Pubmed, Socups and Web of Science were searched to select studies that employed machine learning or microsimulation techniques for the prognosis of dementia. A single backward snowballing was done to identify further studies. A quality checklist was also employed to assess the quality of the evidence presented by the selected studies, and low quality studies were removed. Finally, data from the final set of studies were extracted in summary tables. Results In total 37 papers were included. The data summary results showed that the current research is focused on the investigation of the patients with mild cognitive impairment that will evolve to Alzheimer's disease, using machine learning techniques. Microsimulation studies were concerned with cost estimation and had a populational focus. Neuroimaging was the most commonly used variable. Conclusions Prediction of conversion from MCI to AD is the dominant theme in the selected studies. Most studies used ML techniques on Neuroimaging data. Only a few data sources have been recruited by most studies and the ADNI database is the one most commonly used. Only two studies have investigated the prediction of epidemiological aspects of Dementia using either ML or MS techniques. Finally, care should be taken when interpreting the reported accuracy of ML techniques, given studies' different contexts. © 2017 Dallora et al.This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
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