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- Gonzalez, Manuel Cruz, et al.
(author)
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International feasibility trial on the use of an interactive mobile health platform for cardiac rehabilitation : protocol of the Diversity 1 study
- 2019
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In: BMJ Health & Care Informatics. - : BMJ Publishing Group Ltd. - 2632-1009. ; 26:1
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Journal article (peer-reviewed)abstract
- Introduction: The implementation of home-based cardiac rehabilitation has demonstrated potential to increase patient participation, but the content and the delivering of the programmes varies across countries. The objective of this study is to investigate whether an Australian-validated mobile health (mHealth) platform for cardiac rehabilitation will be accepted and adopted irrespectively from the existing organisational and contextual factors in five different European countries.Methods and analysis: This international multicentre feasibility study will use surveys, preliminary observations and analysis to evaluate the use and the user's perceptions (satisfaction) of a validated mHealth platform in different contextual settings.Ethics and dissemination: This study protocol has been approved by the Australian research organisation CSIRO and the respective ethical committees of the European sites. The dissemination of this trial will serve as a ground for the further implementation of an international large randomised controlled trial which will contribute to an effective global introduction of mHealth into daily clinical practice.
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- Gonzalez, Manuel, et al.
(author)
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Use of eHealth in the management of pulmonary arterial hypertension : review of the literature
- 2020
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In: BMJ Health & Care Informatics. - : BMJ Publishing Group Ltd. - 2632-1009. ; 27:3
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Research review (peer-reviewed)abstract
- BACKGROUND: Pulmonary arterial hypertension (PAH) is a severe chronic condition associated with poor quality of life and high risks of mortality and hospitalisation. The utilisation of novel diagnostic technologies has improved survival rates although the effectiveness of Electronic Health (eHealth) interventions in patients with a chronic cardiopulmonary disease remains controversial. As the effectiveness of eHealth can be established by specific evaluation for different chronic health conditions, the aim of this study was to explore and summarise the utilisation of eHealth in PAH.METHOD: We searched PubMed, CINAHL and Embase for all studies reporting clinical trials on eHealth solutions for the management of PAH. No limitations in terms of study design or date of publication were imposed.RESULTS: 18 studies (6 peer-reviewed journal papers and 12 conference papers) were identified. Seven studies addressed the accuracy, safety or reliability of eHealth technologies such as intra-arterial haemodynamic monitoring of the pulmonary artery pressure, self-administered 6-Minute walk test App, computerised step-pulse oximeter and ambulatory impedance cardiography. Two studies evaluated eHealth as part of the medical management and showed a reduction in hospitalisation rate.CONCLUSIONS: The evidence of eHealth supporting the management of people with PAH is limited and only embraced through a few studies of small sample size and short-term duration. Given the proposed clinical benefits in heart failure, we postulate that the evaluation of eHealth for the clinical management of PAH is highly warranted.
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- Gottliebsen, Kristian, et al.
(author)
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Limited evidence of benefits of patient operated intelligent primary care triage tools : findings of a literature review
- 2020
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In: BMJ Health & Care Informatics. - : BMJ Publishing Group Ltd. - 2632-1009. ; 27:1, s. 1-7
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Research review (peer-reviewed)abstract
- Introduction There is consistent evidence that the workload in general practices is substantially increasing. The digitalisation of healthcare including the use of artificial intelligence has been suggested as a solution to this problem. We wanted to explore the features of intelligent online triage tools in primary care by conducting a literature review.Method A systematic literature search strategy was formulated and conducted in the PubMed database and the Cochrane Library. Articles were selected according to inclusion/exclusion criteria. Results and data were systematically extracted and thematically analysed. 17 articles of that reported large multimethod studies or smaller diagnostic accuracy tests on clinical vignettes were included. Reviews and expert opinions were also considered.Results There was limited evidence on the actual effects and performance of triage tools in primary care. Several aspects can guide further development: concepts of system design, system implementation and diagnostic performance. The most important findings were: a need to formulate evaluation guidelines and regulations; their assumed potential has not yet been met; a risk of increased or redistribution of workloads and the available symptom checker systems seem overly risk averse and should be tested in real-life settings.Conclusion This review identified several features associated with the design and implementation of intelligent online triage tools in a primary care context, although most of the investigated systems seemed underdeveloped and offered limited benefits. Current online triage systems should not be used by individuals who have reasonable access to traditional healthcare. Systems used should be strictly evaluated and regulated like other medical products.
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| 5. |
- Högberg, Charlotte, et al.
(author)
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Anticipating Artificial Intelligence in Mammography Screening : Views of Swedish Breast Radiologists
- 2023
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In: BMJ Health & Care Informatics. - 2632-1009. ; 30:1, s. 1-8
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Journal article (peer-reviewed)abstract
- Objectives: Artificial intelligence (AI) is increasingly tested and integrated into breast cancer screening. Still, there are unresolved issues regarding its possible ethical, social and legal impacts. Furthermore, the perspectives of different actors are lacking. This study investigates the views of breast radiologists on AI-supported mammography screening, with a focus on attitudes, perceived benefits and risks, accountability of AI use, and potential impact on the profession.Methods:We conducted an online survey of Swedish breast radiologists. As early adopter of breast cancer screening, and digital technologies, Sweden is a particularly interesting case to study. The survey had different themes, including: attitudes and responsibilities pertaining to AI, and AI’s impact on the profession. Responses were analysed using descriptive statistics and correlation analyses. Free texts and comments were analysed using an inductive approach.Results:Overall, respondents (47/105, response rate 44.8%) were highly experienced in breast imaging and had a mixed knowledge of AI. A majority (n=38, 80.8%) were positive/somewhat positive towards integrating AI in mammography screening. Still, many considered there to be potential risks to a high/somewhat high degree (n=16, 34.1%) or were uncertain (n=16, 34.0%). Several important uncertainties were identified, such as defining liable actor(s) when AI is integrated into medical decision-making.Conclusions:Swedish breast radiologists are largely positive towards integrating AI in mammography screening, but there are significant uncertainties that need to be addressed, especially regarding risks and responsibilities. The results stress the importance of understanding actor-specific and context-specific challenges to responsible implementation of AI in healthcare.
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- KC, Ashish, 1982-, et al.
(author)
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Usability, acceptability and feasibility of a novel technology with visual guidance with video and audio recording during newborn resuscitation : a pilot study
- 2022
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In: BMJ Health & Care Informatics. - : BMJ Publishing Group Ltd. - 2632-1009. ; 29
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Journal article (peer-reviewed)abstract
- Objective: Inadequate adherence to resuscitation for non-crying infants will have poor outcome and thus rationalise a need for real-time guidance and quality improvement technology. This study assessed the usability, feasibility and acceptability of a novel technology of real-time visual guidance, with sound and video recording during resuscitation.Setting: A public hospital in Nepal.Design: A cross-sectional design.Intervention: The technology has an infant warmer with light, equipped with a tablet monitor, NeoBeat and upright bag and mask. The tablet records resuscitation activities, ventilation sound, heart rate and display time since birth. Healthcare providers (HCPs) were trained on the technology before piloting.Data collection and analysis: HCPs who had at least 8 weeks of experience using the technology completed a questionnaire on usability, feasibility and acceptability (ranged 1-5 scale). Overall usability score was calculated (ranged 1-100 scale).Results: Among the 30 HCPs, 25 consented to the study. The usability score was good with the mean score (SD) of 68.4% (10.4). In terms of feasibility, the participants perceived that they did not receive adequate support from the hospital administration for use of the technology, mean score (SD) of 2.44 (1.56). In terms of acceptability, the information provided in the monitor, that is, time elapsed from birth was easy to understand with mean score (SD) of 4.60 (0.76).Conclusion: The study demonstrates reasonable usability, feasibility and acceptability of a technological solution that records audio visual events during resuscitation and provides visual guidance to improve care.
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| 7. |
- KC, Ashish, 1982, et al.
(author)
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Usability, acceptability and feasibility of a novel technology with visual guidance with video and audio recording during newborn resuscitation: a pilot study.
- 2022
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In: BMJ health & care informatics. - : BMJ. - 2632-1009. ; 29:1
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Journal article (peer-reviewed)abstract
- Inadequate adherence to resuscitation for non-crying infants will have poor outcome and thus rationalise a need for real-time guidance and quality improvement technology. This study assessed the usability, feasibility and acceptability of a novel technology of real-time visual guidance, with sound and video recording during resuscitation.A public hospital in Nepal.A cross-sectional design.The technology has an infant warmer with light, equipped with a tablet monitor, NeoBeat and upright bag and mask. The tablet records resuscitation activities, ventilation sound, heart rate and display time since birth. Healthcare providers (HCPs) were trained on the technology before piloting.HCPs who had at least 8 weeks of experience using the technology completed a questionnaire on usability, feasibility and acceptability (ranged 1-5 scale). Overall usability score was calculated (ranged 1-100 scale).Among the 30 HCPs, 25 consented to the study. The usability score was good with the mean score (SD) of 68.4% (10.4). In terms of feasibility, the participants perceived that they did not receive adequate support from the hospital administration for use of the technology, mean score (SD) of 2.44 (1.56). In terms of acceptability, the information provided in the monitor, that is, time elapsed from birth was easy to understand with mean score (SD) of 4.60 (0.76).The study demonstrates reasonable usability, feasibility and acceptability of a technological solution that records audio visual events during resuscitation and provides visual guidance to improve care.
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| 8. |
- Ronmark, E, et al.
(author)
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Effect of digital-enabled multidisciplinary therapy conferences on efficiency and quality of the decision making in prostate cancer care
- 2022
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In: BMJ health & care informatics. - : BMJ. - 2632-1009. ; 29:1
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Journal article (peer-reviewed)abstract
- To investigate the impact on efficiency and quality of preprostatectomy multidisciplinary therapy conferences (MDT) at Karolinska University Hospital related to the use of a digital solution compared with standard of care. Further, to explore whether gains in MDT efficiency and quality impact oncological or functional patient outcomes.MethodsWe conducted a prospective, observational study of preoperative prostate cancer MDT at Karolinska between February 2017 and March 2021, including 1329 patients. We compared efficiency and quality of the standard MDT and the MDT using the digital solution IntelliSpace Precision Medicine Multidisciplinary Team Orchestrator (ISPM) based on the previously used MDT-MODe approach. Clinical and patient-reported functional outcomes were derived from the medical records and the Swedish National Prostate Cancer Register.ResultsWhile ISPM was used during the MDT meeting, the time spent per patient was reduced by 24% (p<0.001) and most of the MDT-MODe items were scored significantly higher. There was a reduction in pelvic lymph-node dissection procedures in the ISPM cohort (p=0.001) and an increased proportion of unilateral nerve-sparing procedures (p=0.005), while all other outcome-related measures were not significantly different between the two patient groups.Discussion and conclusionTo increase the value of the MDT, all data relevant for treatment decision need to be purposefully presented and compiled, which also enables secondary use of the data.The use of a digital solution during preoperative MDTs for prostate cancer decision making at Karolinska University Hospital improved the efficiency and quality of this multidisciplinary team meeting without impacting patient outcomes.
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