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1.
Osteoporos Int ; 35(9): 1513-1571, 2024 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-38831198

RESUMO

This research conducts a comparative analysis and scoping review of 105 studies in the field of Fracture Liaison Service (FLS). The resulting two-dimensional framework represents a significant step toward FLS implementation. PURPOSE: The primary goal is to review interventions in real world settings in order to provide the FLS framework that specifies the essential elements of its implementation and offers different perspectives on that. METHOD: This study encompasses two phases: a comparative analysis of existing FLS models, including "Capture the Fracture," "5IQ," and "Ganda," and a scoping review from 2012 to 2022 in PubMed, Web of Science, Scopus, ProQuest, and IEEE databases limited to publications in English. RESULTS: The resulting model of comparative analysis identifies patient identification, investigation, intervention and integration or continuity of care as the four main stages of FLS. Additionally, the elements of quality and information span across all stages. Following comparative analysis, the framework is designed to be used for content analysis of the included studies in the scoping review. The intersection of columns (Who, Where, When, What, How, Quality) with rows (Identification, Investigation, Intervention, and continuity of care) yields a set of questions, answered in tabular form based on the scoping review. CONCLUSION: The framework offers potential benefits in facilitating the adoption of effective approaches for FLS implementation. It is recommended to undertake an in-depth review of each of these components in order to uncover novel and innovative approaches for improving their implementation.


Assuntos
Fraturas por Osteoporose , Humanos , Fraturas por Osteoporose/prevenção & controle , Prestação Integrada de Cuidados de Saúde/organização & administração , Continuidade da Assistência ao Paciente/organização & administração , Osteoporose
2.
Future Oncol ; 18(12): 1437-1448, 2022 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-35129376

RESUMO

Background: The present study describes the steps of developing a hybrid teleoncology system to provide treatment plans for breast cancer patients. Materials & methods: This research was conducted in four stages, including developing a proposal for experts, identifying and analyzing system requirements, designing a prototype and implementing and evaluating the final version of the hybrid teleoncology system. Results: The results of the usability evaluation showed that the users evaluated the system at a good level and, in practice, the implemented system was perceived to be useful by specialists in providing treatment plans for cancer patients. Conclusion: The hybrid teleoncology system is a practical alternative to traditional methods for providing treatment plans to breast cancer patients.


Assuntos
Neoplasias da Mama , COVID-19 , Telemedicina , Neoplasias da Mama/diagnóstico , Neoplasias da Mama/terapia , Feminino , Humanos , Oncologia/métodos , Pandemias , Telemedicina/métodos
3.
BMC Med Inform Decis Mak ; 22(1): 167, 2022 06 26.
Artigo em Inglês | MEDLINE | ID: mdl-35761275

RESUMO

BACKGROUND: A disease severity classification system is widely used to predict the survival of patients admitted to the intensive care unit with different diagnoses. In the present study, conventional severity classification systems were compared with artificial intelligence predictive models (Artificial Neural Network and Decision Tree) in terms of the prediction of the survival rate of the patients admitted to the intensive care unit. METHODS: This retrospective cohort study was performed on the data of the patients admitted to the ICU of Ghaemshahr's Razi Teaching Care Center from March 20th, 2017, to September 22nd, 2019. The required data for calculating conventional severity classification models (SOFA, SAPS II, APACHE II, and APACHE IV) were collected from the patients' medical records. Subsequently, the score of each model was calculated. Artificial intelligence predictive models (Artificial Neural Network and Decision Tree) were developed in the next step. Lastly, the performance of each model in predicting the survival of the patients admitted to the intensive care unit was evaluated using the criteria of sensitivity, specificity, accuracy, F-measure, and area under the ROC curve. Also, each model was validated externally. The R program, version 4.1, was used to create the artificial intelligence models, and SPSS Statistics Software, version 21, was utilized to perform statistical analysis. RESULTS: The area under the ROC curve of SOFA, SAPS II, APACHE II, APACHE IV, multilayer perceptron artificial neural network, and CART decision tree were 76.0, 77.1, 80.3, 78.5, 84.1, and 80.0, respectively. CONCLUSION: The results showed that although the APACHE II model had better results than other conventional models in predicting the survival rate of the patients admitted to the intensive care unit, the other conventional models provided acceptable results too. Moreover, the findings showed that the artificial neural network model had the best performance among all the studied models, indicating the discrimination power of this model in predicting patient survival compared to the other models.


Assuntos
Inteligência Artificial , Unidades de Terapia Intensiva , APACHE , Mortalidade Hospitalar , Humanos , Prognóstico , Curva ROC , Estudos Retrospectivos
4.
BMC Med Inform Decis Mak ; 21(1): 98, 2021 03 10.
Artigo em Inglês | MEDLINE | ID: mdl-33691690

RESUMO

BACKGROUND: Clinical Decision Support Systems (CDSSs) for Prescribing are one of the innovations designed to improve physician practice performance and patient outcomes by reducing prescription errors. This study was therefore conducted to examine the effects of various CDSSs on physician practice performance and patient outcomes. METHODS: This systematic review was carried out by searching PubMed, Embase, Web of Science, Scopus, and Cochrane Library from 2005 to 2019. The studies were independently reviewed by two researchers. Any discrepancies in the eligibility of the studies between the two researchers were then resolved by consulting the third researcher. In the next step, we performed a meta-analysis based on medication subgroups, CDSS-type subgroups, and outcome categories. Also, we provided the narrative style of the findings. In the meantime, we used a random-effects model to estimate the effects of CDSS on patient outcomes and physician practice performance with a 95% confidence interval. Q statistics and I2 were then used to calculate heterogeneity. RESULTS: On the basis of the inclusion criteria, 45 studies were qualified for analysis in this study. CDSS for prescription drugs/COPE has been used for various diseases such as cardiovascular diseases, hypertension, diabetes, gastrointestinal and respiratory diseases, AIDS, appendicitis, kidney disease, malaria, high blood potassium, and mental diseases. In the meantime, other cases such as concurrent prescribing of multiple medications for patients and their effects on the above-mentioned results have been analyzed. The study shows that in some cases the use of CDSS has beneficial effects on patient outcomes and physician practice performance (std diff in means = 0.084, 95% CI 0.067 to 0.102). It was also statistically significant for outcome categories such as those demonstrating better results for physician practice performance and patient outcomes or both. However, there was no significant difference between some other cases and traditional approaches. We assume that this may be due to the disease type, the quantity, and the type of CDSS criteria that affected the comparison. Overall, the results of this study show positive effects on performance for all forms of CDSSs. CONCLUSIONS: Our results indicate that the positive effects of the CDSS can be due to factors such as user-friendliness, compliance with clinical guidelines, patient and physician cooperation, integration of electronic health records, CDSS, and pharmaceutical systems, consideration of the views of physicians in assessing the importance of CDSS alerts, and the real-time alerts in the prescription.


Assuntos
Sistemas de Apoio a Decisões Clínicas , Médicos , Registros Eletrônicos de Saúde , Humanos , Prescrições
5.
J Biomed Inform ; 103: 103383, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-32044417

RESUMO

CONTEXT: The current studies on IoT in healthcare have reviewed the uses of this technology in a combination of healthcare domains, including nursing, rehabilitation sciences, ambient assisted living (AAL), medicine, etc. However, no review study has scrutinized IoT advances exclusively in medicine irrespective of other healthcare domains. OBJECTIVES: The purpose of the current study was to identify and map the current IoT developments in medicine through providing graphical/tabular classifications on the current experimental and practical IoT information in medicine, the involved medical sub-fields, the locations of IoT use in medicine, and the bibliometric information about IoT research articles. METHODS: In this systematic mapping study, the studies published between 2000 and 2018 in major online scientific databases, including IEEE Xplore, Web of Science, Scopus, and PubMed were screened. A total of 3679 papers were found from which 89 papers were finally selected based on specific inclusion/exclusion criteria. RESULTS: While the majority of medical IoT studies were experimental and prototyping in nature, they generally reported that home was the most popular place for medical IoT applications. It was also found that neurology, cardiology, and psychiatry/psychology were the medical sub-fields receiving the most IoT attention. Bibliometric analysis showed that IEEE Internet of Things Journal has published the most influential IoT articles. India, China and the United States were found to be the most involved countries in medical IoT research. CONCLUSIONS: Although IoT has not yet been employed in some medical sub-fields, recent substantial surge in the number of medical IoT studies will most likely lead to the engagement of more medical sub-fields in the years to come. IoT literature also shows that the ambiguity of assigning a variety of terms to IoT, namely system, platform, device, tool, etc., and the interchangeable uses of these terms require a taxonomy study to investigate the precise definition of these terms. Other areas of research have also been mentioned at the end of this article.


Assuntos
Internet das Coisas , China , Bases de Dados Factuais , Atenção à Saúde , Internet , Publicações
6.
Chin J Traumatol ; 23(5): 274-279, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32921558

RESUMO

PURPOSE: Child injuries are a public health concern globally. Injury surveillance systems (ISSs) have beneficial impact on child injury prevention. There is a need for evidence-based consensus on frameworks to establish child ISSs. This research aims to investigate the key components of a child ISS for Iran and to propose a framework for implementation. METHODS: Data were gathered through interview with experts using unstructured questions from January 2017 to December 2018 to identify child ISS functional components. Qualitative data were analyzed using content analysis method. Then, modified Delphi method was used to validate the functional components. Based on the outcomes of the content analysis, a questionnaire with closed questions was developed and presented to a group of experts. Consensus was achieved in two rounds. RESULTS: In round I, 117 items reached consensus. In round II, 5 items reached consensus and were incorporated into final framework. Consensus was reached for 122 items comprising the final framework and representing 7 key components: goals of the system, data sources, data set, coalition of stakeholders, data collection, data analysis and data distribution. Each component consisted of several sub-components and respective elements. CONCLUSION: This agreed framework will assist in standardizing data collection, analysis and distribution, which help to detect child injury problems and provide evidence for preventive measures.


Assuntos
Gestão da Segurança/métodos , Inquéritos e Questionários , Ferimentos e Lesões/prevenção & controle , Adolescente , Criança , Pré-Escolar , Análise de Dados , Coleta de Dados , Feminino , Humanos , Lactente , Irã (Geográfico) , Masculino
7.
Chin J Traumatol ; 22(4): 228-232, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31208791

RESUMO

PURPOSE: Child injuries are a global public health problem and injury surveillance systems (ISS) can be beneficial by providing timely data. However, ISS implementation has challenges. Opinions of stakeholders of ISS implementation barriers and facilitators are a good source to understand this phenomenon. The aim of this study is to investigate barriers and facilitators of implementing ISS in Iran. METHODS: This is a qualitative study. Data were gathered through interviews with 14 experts in the field of child injury and prevention from Iranian Ministry of Health and Medical Education (MOHME), medical universities, pediatrics hospitals, general hospitals and health houses during January 2017 to September 2017. Data collection and analysis continued until data saturation. Data were analyzed using content analysis through identifying meaning units. RESULTS: Barriers were classified in three main categories and nine subcategories including management barriers (including performance, coordination and cooperation, supervision and attitude), weakness in data capture and usage (including data collection, data recording and data dissemination) and resource limitation (including human and financial resources). Facilitators identified in three areas of policy making (including empowerment and attitude), management (including organization, function and cooperation and coordination) and data recording and usage (including data collection/distribution and data recording). CONCLUSION: The most important barrier is lack of national policy in child injury prevention. The most important facilitator is improving MOHME function through passing supportive regulations. Effective data usage and dissemination of information to those requiring data for policy making can help reduce child injuries. Coalition of stakeholders helps overcome existing barriers.


Assuntos
Prevenção de Acidentes/métodos , Ferimentos e Lesões/prevenção & controle , Criança , Política de Saúde , Humanos , Entrevistas como Assunto , Irã (Geográfico) , Formulação de Políticas , Pesquisa Qualitativa
8.
J Cancer Educ ; 33(4): 737-748, 2018 08.
Artigo em Inglês | MEDLINE | ID: mdl-28452025

RESUMO

To date, there have been many strategies, including educational interventions, for cancer prevention and control, but most of them are not deaf-tailored ones. This narrative review aimed to examine cancer educational programs to improve the deaf individuals' knowledge and attitude toward cancer. The design of this study is a narrative review. We searched ISI Web of Science, Scopus, Science Direct, and MEDLINE/PubMed using the following search strategy: ("cancer education" AND "deaf") OR ("cancer" AND "deaf" AND literacy). Publication years ranged from 1983 to 2016 for studies on cancer educational interventions for the deaf. Included studies were analyzed regarding research methodologies, types of intervention, and major findings. In total, 12 included studies were classified into three research methodologies. Although short-term and long-term knowledge improvement has been reported, since there is limited evidence on the types of cancer-related educational interventions and there are insufficient studies, longterm effectiveness of educations in improving cancer knowledge of the deaf has to be reported cautiously. Current deaf-tailored education interventions are limited, but included functional features which facilitate communicating cancer health information to the deaf community. In fact, cancer literacy might improve considering deaf community preferences such as using a short open caption, sign language, and plain language in educational interventions, but further research is recommended.


Assuntos
Educação em Saúde , Letramento em Saúde , Neoplasias , Educação de Pacientes como Assunto , Pessoas com Deficiência Auditiva , Língua de Sinais , Acesso à Informação , Atenção à Saúde , Educação em Enfermagem , Educação em Saúde/métodos , Humanos , Conhecimento , Editoração , Pesquisa
9.
Health Info Libr J ; 34(3): 187-199, 2017 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-28726344

RESUMO

BACKGROUND: Nurses' use of electronic literature has remained limited. OBJECTIVES: The aim of this study was to identify barriers concerning application of electronic literature on evidence based practice in nursing. METHODS: Six bibliographic databases were searched using the following keywords: challenges, barriers, obstacles, evidence based practice, EBP, information seeking, online databases, electronic literature, bibliographic databases and nurs*. Results were filtered to peer reviewed empirical studies, written in English or Persian and published from 2010 to 2017. Studies were selected based on specified inclusion criteria, and quality of the included studies was assessed. The approved articles (n = 21) were extracted and synthesised. DISCUSSION: There are different types of barriers in using electronic evidence based literature in nursing demonstrating the issue as a multi-faceted problem. Not having enough time to conduct a search was the first major barrier noted by almost 81% (n = 17) of the reviewed studies followed by lack of knowledge on searching skills (66%; n = 14) and access requirements (38%; n = 8). CONCLUSIONS: There appears to be an important role for hospital management in providing nurses with enough time and access to online information while at work and also for health care librarians together with nursing leaders in providing the required training on using electronic evidence based literature.

10.
Health Care Manag (Frederick) ; 36(3): 301-307, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28657915

RESUMO

Teleradiology is considered as one of the important forms of telemedicine. Positive views of the users and providers of these services play an important role in its successful implementations. The aim of this study was to investigate the views of radiologists used in the radiology departments of teaching hospitals in the Zahedan University of Medical Sciences through teleradiology, as well as evaluate the executive possibility of teleradiology in these hospitals by the views of chief executive officer and comparison between these two views. The current cross-sectional research was performed in 2014 at Zahedan teaching hospitals. The views of 13 chief executive officers on the possibility of the execution of teleradiology and 26 radiologists on the teleradiology process were evaluated by means of two valid and reliable questionnaires. The results of the research revealed that most of the radiologists had knowledge of and positive opinions about teleradiology. Conversely, the view by chief executive officers was that implementation of these processes was not possible in the studied hospitals. Dealing with some issues including data security, controlling or restricting access to clinical information of patients during the process of teleradiology, the possibility of legal protection for the participating radiologists, constitution of executive teams in the organization along with the financial supports, and, subsequently, invitation of the supports from the chief executive officers as the main sponsors of teleradiology implementation in the teaching hospitals are all guidelines for improvement of the successful implementation of teleradiology.


Assuntos
Atitude do Pessoal de Saúde , Radiologistas , Telerradiologia , Pessoal Administrativo , Estudos Transversais , Humanos , Irã (Geográfico) , Telemedicina
11.
Health Care Manag (Frederick) ; 34(1): 28-40, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-25627852

RESUMO

A knowledge management audit (KMA) is the first phase in knowledge management implementation. Incomplete or incomprehensive execution of the KMA has caused many knowledge management programs to fail. A study was undertaken to investigate how KMAs are performed systematically in organizations and present a comprehensive model for performing KMAs based on a systematic review. Studies were identified by searching electronic databases such as Emerald, LISA, and the Cochrane library and e-journals such as the Oxford Journal and hand searching of printed journals, theses, and books in the Tehran University of Medical Sciences digital library. The sources used in this study consisted of studies available through the digital library of the Tehran University of Medical Sciences that were published between 2000 and 2013, including both Persian- and English-language sources, as well as articles explaining the steps involved in performing a KMA. A comprehensive model for KMAs is presented in this study. To successfully execute a KMA, it is necessary to perform the appropriate preliminary activities in relation to the knowledge management infrastructure, determine the knowledge management situation, and analyze and use the available data on this situation.


Assuntos
Gestão do Conhecimento , Auditoria Administrativa/organização & administração , Humanos , Irã (Geográfico) , Modelos Organizacionais
12.
Comput Inform Nurs ; 32(4): 174-81, 2014 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-24469556

RESUMO

Our aim was to use the fuzzy analytic hierarchy process approach to prioritize the factors that influence nurses' satisfaction with a hospital information system. First, we reviewed the related literature to identify and select possible factors. Second, we developed an analytic hierarchy process framework with three main factors (quality of services, of systems, and of information) and 22 subfactors. Third, we developed a questionnaire based on pairwise comparisons and invited 10 experienced nurses who were identified through snowball sampling to rate these factors. Finally, we used Chang's fuzzy extent analysis method to compute the weights of these factors and prioritize them. We found that information quality was the most important factor (58%), followed by service quality (22%) and then system quality (19%). In conclusion, although their weights were not similar, all factors were important and should be considered in evaluating nurses' satisfaction.


Assuntos
Sistemas de Informação Hospitalar , Satisfação no Emprego , Recursos Humanos de Enfermagem/psicologia , Adulto , Feminino , Humanos , Masculino , Inquéritos e Questionários
13.
J Med Syst ; 38(9): 110, 2014 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-25027017

RESUMO

Complicacy of clinical decisions justifies utilization of information systems such as artificial intelligence (e.g. expert systems and neural networks) to achieve better decisions, however, application of these systems in the medical domain faces some challenges. We aimed at to review the applications of these systems in the medical domain and discuss about such challenges. Following a brief introduction of expert systems and neural networks by representing few examples, the challenges of these systems in the medical domain are discussed. We found that the applications of expert systems and artificial neural networks have been increased in the medical domain. These systems have shown many advantages such as utilization of experts' knowledge, gaining rare knowledge, more time for assessment of the decision, more consistent decisions, and shorter decision-making process. In spite of all these advantages, there are challenges ahead of developing and using such systems including maintenance, required experts, inputting patients' data into the system, problems for knowledge acquisition, problems in modeling medical knowledge, evaluation and validation of system performance, wrong recommendations and responsibility, limited domains of such systems and necessity of integrating such systems into the routine work flows. We concluded that expert systems and neural networks can be successfully used in medicine; however, there are many concerns and questions to be answered through future studies and discussions.


Assuntos
Tomada de Decisões Assistida por Computador , Atenção à Saúde , Sistemas Inteligentes , Redes Neurais de Computação , Sistemas de Apoio a Decisões Clínicas , Humanos , Bases de Conhecimento
14.
J Res Med Sci ; 19(1): 57-64, 2014 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-24672566

RESUMO

Many projects on developing Electronic Health Record (EHR) systems have been carried out in many countries. The current study was conducted to review the published data on the utilization of open source EHR systems in different countries all over the world. Using free text and keyword search techniques, six bibliographic databases were searched for related articles. The identified papers were screened and reviewed during a string of stages for the irrelevancy and validity. The findings showed that open source EHRs have been wildly used by source limited regions in all continents, especially in Sub-Saharan Africa and South America. It would create opportunities to improve national healthcare level especially in developing countries with minimal financial resources. Open source technology is a solution to overcome the problems of high-costs and inflexibility associated with the proprietary health information systems.

15.
Digit Health ; 10: 20552076241234624, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38449680

RESUMO

Objectives: Cardiac arrhythmia is one of the most severe cardiovascular diseases that can be fatal. Therefore, its early detection is critical. However, detecting types of arrhythmia by physicians based on visual identification is time-consuming and subjective. Deep learning can develop effective approaches to classify arrhythmias accurately and quickly. This study proposed a deep learning approach developed based on a Chapman-Shaoxing electrocardiogram (ECG) dataset signal to detect seven types of arrhythmias. Method: Our DNN model is a hybrid CNN-BILSTM-BiGRU algorithm assisted by a multi-head self-attention mechanism regarding the challenging problem of classifying various arrhythmias of ECG signals. Additionally, the synthetic minority oversampling technique (SMOTE)-Tomek technique was utilized to address the data imbalance problem to detect and classify cardiac arrhythmias. Result: The proposed model, trained with a single lead, was tested using a dataset containing 10,466 participants. The performance of the algorithm was evaluated using a random split validation approach. The proposed algorithm achieved an accuracy of 98.57% by lead II and 98.34% by lead aVF for the classification of arrhythmias. Conclusion: We conducted an analysis of single-lead ECG signals to evaluate the effectiveness of our proposed hybrid model in diagnosing and classifying different types of arrhythmias. We trained separate classification models using each individual signal lead. Additionally, we implemented the SMOTE-Tomek technique along with cross-entropy loss as a cost function to address the class imbalance problem. Furthermore, we utilized a multi-headed self-attention mechanism to adjust the network structure and classify the seven arrhythmia classes. Our model achieved high accuracy and demonstrated good generalization ability in detecting ECG arrhythmias. However, further testing of the model with diverse datasets is crucial to validate its performance.

16.
Neurosci Biobehav Rev ; 161: 105634, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38494122

RESUMO

Autism Spectrum Disorder (ASD) is a complex neurological condition that significantly impacts individuals' daily lives and social interactions due to challenges in verbal and non-verbal communication. Game-based tools for psychological support and patient education are rapidly gaining traction. Among these tools, teaching social skills via serious games has emerged as a particularly promising educational strategy for addressing specific characteristics associated with autism. Unlike traditional games, serious games are designed with a dual purpose: to entertain and to fulfill a specific educational or therapeutic goal. This systematic review aims to identify and categorize serious computer games that have been used to teach social skills to autistic individuals and to assess their effectiveness. We conducted a comprehensive search across seven databases, resulting in the identification and analysis of 25 games within 26 studies. Out of the 104 criteria assessed across these studies, 57 demonstrated significant improvement in participants. Furthermore, 22 of these studies reported significant enhancements in at least one measured criterion, with 13 studies observing significant improvements in all assessed outcomes. These findings overwhelmingly support the positive impact of computer-based serious game interventions in teaching social skills to autistic individuals.


Assuntos
Habilidades Sociais , Jogos de Vídeo , Humanos , Transtorno do Espectro Autista/reabilitação , Transtorno do Espectro Autista/terapia , Transtorno Autístico/psicologia , Transtorno Autístico/terapia , Transtorno Autístico/reabilitação
17.
Iran J Pharm Res ; 21(1): e123821, 2022 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-35765500

RESUMO

Evaluation of electronic prescribing systems (EPS) can contribute to their quality assurance, and motivate users and policy-makers to implement these systems, directly influencing the health of society. An appropriate evaluation tool plays a determining role in the identification of proper EPS. The present study aimed to develop a multifaceted evaluation tool for assessing the EPS. This study was conducted in two main steps in 2018. In the first step, we conducted a literature review to find the main features and capabilities of the prosperous EPS. In the second step, a Delphi method was used for determining the final criteria for evaluating EPS. After preparing a primary questionnaire based on the first step results, 27 expert stakeholders from related fields participated in this 3-phase Delphi study. The narrative content analysis and descriptive statistics were used for data analysis. The final evaluation tool consists of 61 questions in 10 main dimensions, including practical capabilities of the process/user and patient safety, data storage and transfer, prescription control and renewal, technical functions, user interfaces, security and privacy, reporting, portability, hardware and infrastructure, and system failure/recovery. The evaluation tool developed in this study can be used for the critical appraisal of features of EPS. It is recommended that this multifaceted evaluation tool be employed to help buyers compare different systems and assist EPS software vendors in prioritizing their activities regarding the system development. By using this tool, healthcare organizations can also choose a system that improves many aspects of health care.

18.
Appl Clin Inform ; 13(3): 720-740, 2022 05.
Artigo em Inglês | MEDLINE | ID: mdl-35617971

RESUMO

BACKGROUND: Acute coronary syndrome is the topmost cause of death worldwide; therefore, it is necessary to predict major adverse cardiovascular events and cardiovascular deaths in patients with acute coronary syndrome to make correct and timely clinical decisions. OBJECTIVE: The current review aimed to highlight algorithms and important predictor variables through examining those studies which used machine learning algorithms for predicting major adverse cardiovascular events in patients with acute coronary syndrome. METHODS: To predict major adverse cardiovascular events in patients with acute coronary syndrome, the preferred reporting items for scoping reviews guidelines were used. In doing so, PubMed, Embase, Web of Science, Scopus, Springer, and IEEE Xplore databases were searched for articles published between 2005 and 2021. The checklist "Quality assessment of machine learning studies" was used to assess the quality of eligible studies. The findings of the studies are presented in the form of a narrative synthesis of evidence. RESULTS: In total, among 2,558 retrieved articles, 22 studies were qualified for analysis. Major adverse cardiovascular events and mortality were predicted in 5 and 17 studies, respectively. According to the results, 14 (63.64%) studies did not perform external validation and only used registry data. The algorithms used in this study comprised, inter alia, Regression Logistic, Random Forest, Boosting Ensemble, Non-Boosting Ensemble, Decision Trees, and Naive Bayes. Multiple studies (N = 20) achieved a high area under the ROC curve between 0.8 and 0.99 in predicting mortality and major adverse cardiovascular events. The predictor variables used in these studies were divided into demographic, clinical, and therapeutic features. However, no study reported the integration of machine learning model into clinical practice. CONCLUSION: Machine learning algorithms rendered acceptable results to predict major adverse cardiovascular events and mortality outcomes in patients with acute coronary syndrome. However, these approaches have never been integrated into clinical practice. Further research is required to develop feasible and effective machine learning prediction models to measure their potentially important implications for optimizing the quality of care in patients with acute coronary syndrome.


Assuntos
Síndrome Coronariana Aguda , Síndrome Coronariana Aguda/complicações , Algoritmos , Teorema de Bayes , Humanos , Aprendizado de Máquina , Sistema de Registros
19.
Life (Basel) ; 12(11)2022 Nov 19.
Artigo em Inglês | MEDLINE | ID: mdl-36431068

RESUMO

Background and Objective: Coronary artery disease (CAD) is one of the most prevalent causes of death worldwide. The early diagnosis and timely medical care of cardiovascular patients can greatly prevent death and reduce the cost of treatments associated with CAD. In this study, we attempt to prepare a new model for early CAD diagnosis. The proposed model can diagnose CAD based on clinical data and without the use of an invasive procedure. Methods: In this paper, machine-learning (ML) techniques were used for the early detection of CAD, which were applied to a CAD dataset known as Z-Alizadeh Sani. Since this dataset has 54 features, the Pearson correlation feature selection method was conducted to identify the most effective features. Then, six machine learning techniques including decision tree, deep learning, logistic regression, random forest, support vector machine (SVM), and Xgboost were employed based on a semi-random-partitioning framework. Result: Applying Pearson feature selection to the dataset demonstrated that only eight features were the most effective for CAD diagnosis. The results of running the six machine-learning models on the selected features showed that logistic regression and SVM had the same performance with 95.45% accuracy, 95.91% sensitivity, 91.66% specificity, and a 96.90% F1 score. In addition, the ROC curve indicates a similar result regarding the AUC (0.98). Conclusions: Prediction is an important component of medical decision support systems. The results of the present study showed that feature selection has a high impact on machine-learning performance and, regardless of the evaluation metrics of the machine-learning models, determining the effective features is very important. However, SVM and Logistic Regression were designated as the best models according to our selected features.

20.
Tanaffos ; 21(2): 193-200, 2022 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-36879741

RESUMO

Background: The two main pillars of asthma management include regular follow-up and using guidelines in the treatment process. Patient portals enable regular follow-up of disease, and guideline-based decision-support-systems can improve the use of guidelines in the treatment process. Based on the Global Initiative for Asthma (GINA) and Snell's drug interaction, asthma management system in primary care (AMSPC) includes the capabilities of both mentioned systems. This system was developed to improve regular follow-up and use GINA in the asthma management process. This study aimed to assess the accuracy and usability of the AMSPC based on the GINA and Snell's drug interaction. Materials and Methods: To assess the accuracy of the system, kappa test was used to calculate the degree of agreement between the suggestions made by the system and the physician's decision for a total of 64 patients selected through convenience sampling method. To assess usability, the Questionnaire for User Interface Satisfaction (QUIS) was used. Results: The scores of the Kappa for the agreements between the system and the physician in determining "drug type and dosage", "follow-up time", and "drug interactions" were 0.90, 0.94, and 0.94, respectively. The average score of the QUIS was 8.6 out of 9. Conclusion: Due to the high accuracy of the system in computerizing the GINA and Snell's drug interaction, as well as its proper usability, it is expected that the system be widely used to improve asthma management and reduce drug interactions.

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