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BACKGROUND: Providing appropriate specialized treatment to the right patient at the right time is considered necessary in cancer management. Targeted therapy tailored to the genetic changes of each breast cancer patient is a desirable feature of precision oncology, which can not only reduce disease progression but also potentially increase patient survival. The use of artificial intelligence alongside precision oncology can help physicians by identifying and selecting more effective treatment factors for patients. METHOD: A systematic review was conducted using the PubMed, Embase, Scopus, and Web of Science databases in September 2023. We performed the search strategy with keywords, namely: Breast Cancer, Artificial intelligence, and precision Oncology along with their synonyms in the article titles. Descriptive, qualitative, review, and non-English studies were excluded. The quality assessment of the articles and evaluation of bias were determined based on the SJR journal and JBI indices, as well as the PRISMA2020 guideline. RESULTS: Forty-six studies were selected that focused on personalized breast cancer management using artificial intelligence models. Seventeen studies using various deep learning methods achieved a satisfactory outcome in predicting treatment response and prognosis, contributing to personalized breast cancer management. Two studies utilizing neural networks and clustering provided acceptable indicators for predicting patient survival and categorizing breast tumors. One study employed transfer learning to predict treatment response. Twenty-six studies utilizing machine-learning methods demonstrated that these techniques can improve breast cancer classification, screening, diagnosis, and prognosis. The most frequent modeling techniques used were NB, SVM, RF, XGBoost, and Reinforcement Learning. The average area under the curve (AUC) for the models was 0.91. Moreover, the average values for accuracy, sensitivity, specificity, and precision were reported to be in the range of 90-96% for the models. CONCLUSION: Artificial intelligence has proven to be effective in assisting physicians and researchers in managing breast cancer treatment by uncovering hidden patterns in complex omics and genetic data. Intelligent processing of omics data through protein and gene pattern classification and the utilization of deep neural patterns has the potential to significantly transform the field of complex disease management.
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Inteligência Artificial , Neoplasias da Mama , Medicina de Precisão , Humanos , Neoplasias da Mama/terapia , Neoplasias da Mama/genética , Medicina de Precisão/métodos , Feminino , Prognóstico , Aprendizado de Máquina , Redes Neurais de ComputaçãoRESUMO
OBJECTIVE: Chemotherapy medication errors are catastrophic. The prescription phase in the chemotherapy process plays a key role in the creation of medication errors, and therefore the use of computerized physician order entry (CPOE) and clinical decision support system (CDS) systems is recommended to reduce chemotherapy medication errors. The purpose of this study was to carry out a systematic review on the specifications of the CPOE and CDS systems for chemotherapy prescription. MATERIALS AND METHODS: A systematic review on articles published in English up to September 22, 2017, using the 3 databases PubMed, Embase, and Medline was conducted. Those articles that focused on the specifications of CPOE and CDSS in chemotherapy prescription were included in this review. FINDINGS: Of the 2,471 articles identified, 58 articles met the inclusion criteria and were included in this study. Specifications related to chemotherapy CPOE systems were categorized into the following 6 groups: automation and facilitation of the chemotherapy prescription phase, hospital workflow support, documentation and reporting, drug safety, information security, and system communications. The specifications of chemotherapy CDSS were also divided into 4 categories: embedding chemotherapy protocols, automated dose calculations and adjustment, providing alerts/reminders at the time of prescribing, and guiding or asking the user to complete the important prescription parameters. In 12 articles, the chemotherapy prescription CDSS were designed and evaluated independently of the CPOE; 45 articles provided prescription chemotherapy CDSS as part of the CPOE system, and in 1 article CPOE was introduced with no CDSS. CONCLUSION: In complicated settings such as chemotherapy, simplification of the processes is more imperative. The use of chemotherapy CPOE, which includes specifications for helping the medical staff with their workload, encourages the professionals to use such systems and increases the likelihood for success of these systems.
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Antineoplásicos/uso terapêutico , Sistemas de Apoio a Decisões Clínicas , Neoplasias/tratamento farmacológico , Bases de Dados Factuais , Humanos , Sistemas de Registro de Ordens Médicas , Erros de Medicação/prevenção & controle , Neoplasias/patologiaRESUMO
Although patients on hemodialysis require effective education for self-care, several issues associated with the process raise barriers that make learning difficult. Computer-based education can reduce these problems and improve the quality of education. This study aims to develop and validate a theory-based multimedia application to educate Persian patients on hemodialysis. The study consisted of five phases: (1) content development, (2) prototype development 1, (3) evaluation by users, (4) evaluation by a multidisciplinary group of experts, and (5) prototype development 2. Data were collected through interviews and literature review with open-ended questions and two survey forms that consisted of a five-level scale. In the Results section, patient needs on hemodialysis self-care and related content were categorized into seven sections, including kidney function and failure, hemodialysis, vascular access, nutrition, medication, physical activity, and living with hemodialysis. The application designed includes seven modules consisting of user-controlled small multimedia units. During navigation through this application, the users were provided step-by-step information on self-care. Favorable scores were obtained from evaluations by users and experts. The researchers concluded that this application can facilitate hemodialysis education and learning process for the patients by focusing on their self-care needs using the multimedia design principles.
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Instrução por Computador/métodos , Educação de Pacientes como Assunto/métodos , Diálise Renal , Adulto , Feminino , Humanos , Aprendizagem , Masculino , Pessoa de Meia-Idade , Multimídia , Autocuidado , Interface Usuário-ComputadorRESUMO
Background: Since colorectal cancer is one of the most important types of cancer in the world that often leads to death, computer-aided diagnostic (CAD) systems are a promising solution for early diagnosis of this disease with fewer side effects than conventional colonoscopy. Therefore, the aim of this research is to design a CAD system for processing colorectal Computerized Tomography (CT) images using a combination of an artificial neural network and a particle swarm optimizer. Method: First, the data set of the research was created from the colorectal CT images of the patients of Loghman-e Hakim Hospitals in Tehran and Al-Zahra Hospitals in Isfahan who underwent colorectal CT imaging and had conventional colonoscopy done within a maximum period of one month after that. Then the steps of model implementation, including electronic cleansing of images, segmentation, labeling of samples, extraction of features, and training and optimization of the artificial neural network (ANN) with a particle swarm optimizer, were performed. A binomial statistical test and confusion matrix calculation were used to evaluate the model. Results: The values of accuracy, sensitivity, and specificity of the model with a P value = 0.000 as a result of the McNemar test were 0.9354, 0.9298, and 0.9889, respectively. Also, the result of the P value of the binomial test of the ratio of diagnosis of the model and the radiologist from Loqman Hakim and Al-Zahra Hospitals was 0.044 and 0.021, respectively. Conclusions: The results of statistical tests and research variables show the efficiency of the CTC-CAD system created based on the hybrid of the ANN and particle swarm optimization compared to the opinion of radiologists in diagnosing colorectal polyps from CTC images.
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BACKGROUND: Diagnostic imaging decision support (DI-DS) systems could be effective tools for reducing inappropriate diagnostic imaging examinations. Since effective design and evaluation of these systems requires in-depth understanding of their features and functions, the present study aims to map the existing literature on DI-DS systems to identify features and functions of these systems. METHODS: The search was performed using Scopus, Embase, PubMed, Web of Science, and Cochrane Central Registry of Controlled Trials (CENTRAL) and was limited to 2000 to 2021. Analytical studies, descriptive studies, reviews and book chapters that explicitly addressed the functions or features of DI-DS systems were included. RESULTS: A total of 6,046 studies were identified. Out of these, 55 studies met the inclusion criteria. From these, 22 functions and 22 features were identified. Some of the identified features were: visibility, content chunking/grouping, deployed as a multidisciplinary program, clinically valid and relevant feedback, embedding current evidence, and targeted recommendations. And, some of the identified functions were: displaying an appropriateness score, recommending alternative or more appropriate imaging examination(s), providing recommendations for next diagnostic steps, and providing safety alerts. CONCLUSIONS: The set of features and functions obtained in the present study can provide a basis for developing well-designed DI-DS systems, which could help to improve adherence to diagnostic imaging guidelines, minimize unnecessary costs, and improve the outcome of care through appropriate diagnosis and on-time care delivery.
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Sistemas de Apoio a Decisões Clínicas , Diagnóstico por Imagem , Humanos , Atenção à SaúdeRESUMO
OBJECTIVE AND BACKGROUND: Today, e-health plays a significant role in enhancing the quality of healthcare services. However, noticeable differences still exist in developing and applying e-health across the world. The aim of the current study is to present a model for assessing e-health status in different countries. MATERIALS AND METHODS: This study was conducted using a cross-sectional design. Five indicators were determined, and the combination of the indicators was considered as "e-health status indicators." At the next stage, a weight coefficient was assigned to each indicator. Then the identified information and communication technology by the International Telecommunication Union (ITU) composed of four groups was assigned as a basis for sampling. One-third of each group of the ranking was selected randomly, and ultimately scores of the indicators were calculated for each country. Then the status of e-health was determined for countries under study, in particular for Iran. The validity of the tool was evaluated through content validity, and the test-retest method was used to check the reliability. RESULTS: The current study resulted in developing a model for measuring e-health status. The model helped to measure the e-health status score for Iran and other countries under study. CONCLUSIONS: The model designed in this study can be used by organizations such as the ITU to grade countries according to their e-health status. According to the model, countries with a higher e-health grade could have a higher chance of success in e-health development and deployment.
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Saúde Global , Sistemas de Informação/estatística & dados numéricos , Telemedicina/estatística & dados numéricos , Estudos Transversais , Registros Eletrônicos de Saúde/normas , Registros Eletrônicos de Saúde/estatística & dados numéricos , Humanos , Sistemas de Informação/normas , Capacitação em Serviço , Indicadores de Qualidade em Assistência à Saúde , Telemedicina/normasRESUMO
Laboratory services are a crucial part of medical care and contribute to physicians' treatment-related decision-making. However, paper-based information exchanges between physicians' offices and laboratories waste physicians' time and prevent them from using outpatient test results in a timely and effective manner. To solve this problem, improve the safety and quality of patient care, and save patients' time and energy, the present study developed a web-based system for electronic information exchange between laboratories and offices in Microsoft Visual Studio with the ASP.net technology and the Microsoft SQL Server database. The developed web-based software met the needs of the users and stakeholders (physicians, laboratory personnel, and patients) in the laboratory service cycle. To evaluate the software, user satisfaction was assessed in terms of user interface, operational functionality, and system performance, indicating the acceptability of all the criteria from the viewpoint of the stakeholders. The developed web-based software enables electronic communication between offices and laboratories (two important healthcare bases), establishes information exchange (sending requests and receiving laboratory results) between these two bases, and also notifies the patients. The software gained the overall satisfaction of the users, and this highlights the need for electronic communications in the healthcare domain.
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Consultórios Médicos , Médicos , Eletrônica , Humanos , Laboratórios , SoftwareRESUMO
Introduction: Interactive dashboards can collect data from various information sources and be used nationally and internationally. These information systems have played an important role in managing and controlling epidemic diseases, especially Covid-19. This study aimed to identify the applications, features, and key indicators of advanced dashboards in Covid-19. Method: The present article is a systematic review study that searched the PubMed, Scopus, and ISI web of sciences databases in 2021 by combining the relevant keywords. After applying the inclusion and exclusion criteria and selecting articles, data collection was prepared using a data collection form. Data analysis was performed using the content analysis method. Results: Out of 171 articles retrieved, 19 were included in the study for review by applying inclusion and exclusion criteria in the first stage. The most important data sources for the studied dashboards included general online, national, and hospital databases. Monitoring and tracking in the target community and resource management (hospital and public) are the most important issues in Covid-19 dashboards. The study showed that KPIs in 5 main categories of indicators related to hospital beds, clinical data in the hospital, diagnostic and therapeutic measures of hospitals, epidemiological data at the level community, and follow-up indicators of Covid-19 studies were worldwide. Conclusion: Considering the technological advances at the world level and the large amount of data produced, one of the effective solutions for managing and controlling epidemic and pandemic conditions and diseases is the rapid development of interactive dashboards; Therefore, it is suggested that health officials and policymakers, in addition to developing and updating the existing dashboards in the field of Covid-19, developing the dashboard immediately in case of similar conditions.
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Objective: In this survey, a protocol-based Chemotherapy Prescription Decision Support System (CPDSS) was designed and evaluated to reduce medication errors in the chemotherapy process of children with ALL. Methods: The CPDSS algorithm was extracted by the software development team based on the protocol used by doctors to treat children with ALL. The ASP.Net MVC and SQL Server 2016 programming languages were used to develop the system. A 3-step evaluation (technical, retrospective, and user satisfaction) was performed on CPDSS designed at 2 children's hospitals in Tehran. The data were analyzed using descriptive statistics. At the technical evaluation step, users provided recommendations included in the system. Results: In the retrospective CPDSS evaluation step, 1281 prescribed doses of the drugs related to 30 patients were entered into the system. CPDSS detected 735 cases of protocol deviations and 57 (95%, CI = 1.25-2.55) errors in prescribed chemotherapy for children with ALL. In the user satisfaction evaluation, the users approved two dimensions of the user interface and functionality of the system. Conclusions: With the provision of alerts, the CPDSS can help increase compliance with chemotherapy protocols and decrease the chemotherapy prescribing errors that can improve patient safety.
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Introduction: The personal health record (PHR) makes it possible for patients to access, manage, track, and share their health information. By engaging patients in chronic disease care, they will be active members in decision-making and healthcare management. Objectives: This study aimed to identify the functions and outcomes of PHR for patients with four major groups of chronic diseases (cardiovascular diseases, cancers, diabetes, and chronic respiratory diseases). Method: A systematic review was conducted on studies published in PubMed, Scopus, Web of Science, and Embase. Searching and screening were performed using the keyword of "Personal Health Record" without time limitation, and ended in August 2018. Results: In total, 3742 studies were retrieved, 35 of which met the inclusion criteria. Out of these 35, 18 studies were conducted in the United States, 24 studies were related to patients with diabetes, and 32 studies focused on tethered PHRs. Moreover, in 25 studies, the function of viewing and reading medical records and personal health information was provided for three groups of chronic patients. Results showed that the use of PHRs helps the management and control of chronic diseases (10 studies). Conclusion: It is recommended that integrated PHRs with comprehensive functions and features were designed in order to support patient independence and empowerment in self-management, decrease the number of referrals to health centers, and reduce the costs imposed on families and society.
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Doença Crônica , Registros de Saúde Pessoal , Participação do Paciente , Tomada de Decisões , Humanos , PneumopatiasRESUMO
INTRODUCTION: Effective information management in the emergency department (ED) can improve the control and management of ED processes. Dashboards, known as data management tools, efficiently provide information and contribute greatly to control and management of ED. This study aimed to identify performance indicators quality dashboard functionalities, and analyze the challenges associated with dashboard implementation in the ED. METHODS: This systematic review began with a search in four databases (Web of Science, PubMed, Embase, and Scopus) from 2000 to May 30, 2020, when the final search for papers was conducted. The data were collected using a data extraction form and the contents of the extracted papers were analyzed through ED performance indicators, dashboard functionalities, and implementation challenges. RESULTS: Performance indicators reported in the reviewed papers were classified as the quality of care, patient flow, timeliness, costs, and resources. The main dashboard functionalities noted in the papers included reporting, customization, alert creation, resource management, and real-time information display. The dashboard implementation challenges included data sources, data quality, integration with other systems, adaptability of dashboard functionalities to user needs, and selection of appropriate performance indicators. CONCLUSIONS: Quality dashboards facilitate processes, communication, and situation awareness in the ED; hence, they can improve care provision in this department. To enhance the effectiveness and efficiency of ED dashboards, officials should set performance indicators and consider the conformity of dashboard functionalities with user needs. They should also integrate dashboards with other relevant systems at the departmental and hospital levels.
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INTRODUCTION: Effective crisis management can reduce the costs and consequences of a crisis and has a significant impact on saving human lives in critical situations. Proper use of information and communication technologies (ICTs) can improve all crisis management phases and crisis communication cycles according to the needs of stakeholders. The purpose of this review article is to identify which ICTs have been used in effective crisis management and what managerial tasks they support. METHOD: A systematic review was conducted based on PRISMA protocol. The investigated articles that have been published in English were all indexed in PubMed, Science Direct, IEEE, Web of Science, and Google Scholar databases from 2005 to 2019. The keywords searched were "Crisis Management," "Emergency Management," "Information and Communication Technology," and their synonyms. RESULTS: A total of 1,703 articles were retrieved, and 81 articles that met the inclusion criteria were retained. In terms of content, there were 54 case studies/review articles, 38 proposals, and seven prototypes among which 18 case studies and proposals were the same. According to surveys, 18 ICT tools and technologies have been used in effective crisis management with the purpose of supporting managerial tasks such as situation assessment, decision-making, coordination/command and control, communication with the public, and supply of basic services in order to enable crisis management and logistics. CONCLUSION: This study showed that proper use of ICT can help crisis managers optimize their performance that will consequently result in effective crisis management and the reduction of casualties. In the crisis management cycle, several tools and technologies have been used for various purposes, however; some crisis managers' tasks were still not taken into consideration sufficiently, and thus, some recommendations for further research in this field were provided.
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Comunicação , HumanosRESUMO
BACKGROUND: The National Health Information Network (NHIN) is one of the key issues in health information systems in any country. However, the development of this network should be based on an appropriate framework. Unfortunately, the conducted projects of health information systems in the Ministry of Health of Iran do not fully comply with the concept of NHIN. The present study was aimed to develop a general framework for NHIN in Iran. MATERIALS AND METHODS: In this study, in the first stage, the required information about the concept of the NHIN framework and related NHIN documents in the USA and the UK were collected based on a literature review. Then, according to the results of the first stage and with regards to the structure of the Iranian health system, a general framework for Iranian NHIN was proposed. The Delphi technique was conducted to verify the framework. RESULTS: The proposed framework for Iranian NHIN includes three dimensions; components, principles, and architecture. Over 80% of experts have evaluated all three aspects of the framework at an acceptable scale. In total, the proposed framework has been evaluated by 83.8% of the experts at an acceptable scale. CONCLUSION: The proposed framework was expected to serve as the starting point for moving towards the design and creation of Iranian NHIN. At any rate, the framework could be criticized, and it could only be used for the countries whose health system is similar to the structure of the health system in Iran.
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With regard to the importance of health Information Governance (IG) programs in improving the quality and reducing the cost of healthcare services and the lack of a coherent health IG program in Iran's health system, this study aimed to develop a model for national health information governance program in Iran. The present research was an applied, cross-sectional descriptive study that was done in three steps, including literature review, development of a model for national health IG program in Iran, and model validation. In the third step, we used a questioner to validate the model through the Delphi method. Data analysis was done by descriptive statistics. The model for the national IG program in Iran was developed in 3 main sections consisting of 13 components, 12 principles, natural and judicial authorities of the health IG program, and their job description. Findings from the validation of the initial model showed that most experts (93%) confirmed the components and sub-components, principles, and natural and legal bodies supervising the national health IG program and their job description in the proposed model. Considering the structure of the Iranian health system, it was recommended to establish a health IG council in the Ministry of Health and Medical Education in order to develop guidelines and give advice to health care providers. Based on the proposed model, directors and staff of different departments of health care centers, especially those involved in health IG, are also responsible for the better implementation of the national health IG program.
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Governança Clínica , Sistemas de Informação em Saúde , Modelos Teóricos , Estudos Transversais , Técnica Delphi , Humanos , Irã (Geográfico)RESUMO
Laboratory services form an integral part of medical care in the decision-making of physicians, including those working at ambulatory care centers. Information exchange is essential between ambulatory care centers and laboratories. Inevitable errors have always existed in the exchange of such information on paper, which can be to some extent avoided by developing appropriate computer-based interfaces. Therefore, this review aimed to examine studies conducted to determine the effect of electronic communication between ambulatory care centers and laboratories. This systematic review was conducted on the basis of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Studies were searched in the PubMed, Embase, Cochrane, and Web of Science, and those written in English and published between 2000 and February 2019 with full texts available were selected. From a total of 3898 papers retrieved from the studied databases, 24 papers were eligible for entering this study after removing similar and nonrelated studies. Electronic exchanges between ambulatory care centers and laboratories can have numerous benefits in terms of financial, organizational, and quality. This evidence for the value of electronic communications is an important factor contributing to its local investment and adoption.
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Sistemas de Informação em Atendimento Ambulatorial/normas , Sistemas de Informação em Laboratório Clínico/normas , Comunicação , Sistemas de Informação em Atendimento Ambulatorial/organização & administração , Sistemas de Informação em Laboratório Clínico/organização & administraçãoRESUMO
INTRODUCTION: The wide range of notifiable diseases and the need for immediate reporting complicate the management of these diseases. Developing a surveillance system using precise architectural principles could ease the management of these diseases. AIM: The present study reviews the data architecture of notifiable diseases surveillance systems to provide a basis for developing such systems. METHODS: A systematic review was conducted on the literature focused on data architecture of notifiable diseases surveillance systems. The searches for relevant English language articles were conducted based on the paper keywords, as well as the words Mesh and EMTREE. RESULTS: The findings were categorized into five groups, including organizations involved in the generation and monitoring of notifiable diseases' data. The databases in the present study were relational and used a centralized architecture for information sharing. The minimum dataset was determined in two information categories. The data standards were categorized into three main groups. The key approaches for data quality control included checking the completeness, timeliness, accuracy, consistency, adequacy, and validity of the data. CONCLUSION: Developing a notifiable diseases surveillance based on data architecture principles could lay the foundation for better management of such diseases through eliminating the obstacles experienced during data generation, data processing, and data sharing.
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INTRODUCTION AND GOAL: Currently, 1-2% of the population in developed countries are under treatment with oral anticoagulants. An appropriate strategy to deal with this increase in demand of treatment with oral anticoagulants and to manage the costs is the transfer of part or all of the responsibility for managing treatment to the patients. The use of information technology, particularly electronic health software, can be an appropriate method to improve the quality of self-management of treatment with these drugs. Therefore, this systematic review investigated studies that discuss the characteristics of electronic health software in self-management of oral anticoagulation therapy. METHOD: A systematic review based on PRISMA protocol was conducted. In this study, articles were investigated that were in English. Articles existing in Cochrane, EMBASE and PubMed databases were searched up to 14 May 2017. Then, articles searched through Google Scholar were added to this study. FINDINGS: The common characteristics used in most software included 'encryption in exchanging information', having an 'instruction module' and 'being Android-based'. In terms of functionality, 'communication between the patient and healthcare team' existed in most of the software. CONCLUSION: The results of the study showed that the accuracy of administration of the dose of the drug using computer to reach a target international normalized ratio level was not less than those administered with experienced medical staff. In addition, the results indicated that important characteristics of the software include encryption in exchanging information, instruction module and Android-based instruction module. The most important characteristic was the interaction between the patient and the healthcare team.
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Anticoagulantes/uso terapêutico , Autogestão/métodos , Software , Terapia Assistida por Computador/métodos , Deficiência de Vitamina K/terapia , Vitamina K/antagonistas & inibidores , Vitamina K/uso terapêutico , Administração Oral , Adulto , Idoso , Idoso de 80 Anos ou mais , Gerenciamento Clínico , Feminino , Humanos , Coeficiente Internacional Normatizado , Masculino , Pessoa de Meia-IdadeRESUMO
Coronary catheterization is the gold standard for diagnosis and treatment of cardiovascular conditions. The development of a catheterization and percutaneous coronary intervention (CathPCI) registry considering key steps of data management has a pivotal role in coronary catheterization because it could help improve CathPCI approaches, develop equipment and devices, and minimize complications of the CathPCI procedure. Data management comprises data gathering, data processing, and information distribution. Data gathering involves the collection of data elements, including demographics, episode of care, history and relevant risk factors, visits to the catheterization laboratory, diagnosis of cardiac catheterization, estimation of the coronary arterial anatomy, percutaneous coronary intervention procedures, lesions, devices, outcomes, and discharge. Data processing is performed with respect to the number of procedures performed in different circumstances, the outcomes of the performed procedures, improvement in the healthcare approach, development of devices and equipment, and the quality of the performed procedures. Information distribution involves the sharing of information and making information accessible to researchers and clinicians, relevant health care managers, and manufacturers of medical devices and equipment. This study reviewed relevant English-language publications regarding cardiac catheterization registries, data collection, data processing, and information distribution, regardless of the date of publication.
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Cateterismo Cardíaco/métodos , Doenças Cardiovasculares/cirurgia , Gestão da Informação em Saúde/organização & administração , Intervenção Coronária Percutânea/métodos , Sistema de Registros/estatística & dados numéricos , Algoritmos , Cateterismo Cardíaco/estatística & dados numéricos , Doenças Cardiovasculares/diagnóstico , Coleta de Dados/métodos , Gestão da Informação em Saúde/normas , Humanos , Intervenção Coronária Percutânea/estatística & dados numéricos , Procedimentos Cirúrgicos Robóticos/métodos , Procedimentos Cirúrgicos Robóticos/estatística & dados numéricosRESUMO
OBJECTIVE: To carry out a systematic review of studies assessing the effects of chemotherapy prescription clinical decision-support systems (CDSSs) on the chemotherapy process. METHODS: Articles published in English before May 1, 2017 and indexed in the PubMed and Embase databases were reviewed systematically. Studies that focused on the effects of chemotherapy prescription CDSSs on the chemotherapy process were included in this research and reviewed. RESULTS: 2283 articles were retrieved, of which 37 met the inclusion criteria. Twenty-seven of the included studies reported the effect of chemotherapy prescription CDSSs on medication errors, 18 studies focused on user satisfaction and system acceptance, 10 articles studied the effect of CDSSs on costs and care time and only 3 studies examined the impact on compliance with chemotherapy protocols. DISCUSSION AND CONCLUSION: In most of the studies, the use of CDSSs in chemotherapy prescription has reduced medication errors, especially dosage errors and has also reduced the time of chemotherapy process takes. However, in a few studies, the system has not been effective in reducing medication errors, has increased certain type of errors or has introduced new errors. Most of the software used has been specifically designed for the chemotherapy process and is intended to increase user satisfaction and system acceptance. There was not sufficient evidence on the effects of these systems on compliance with protocols and chemotherapy costs to draw firm conclusion. Higher quality studies are required to provide more evidence on the effects of CDSSs on medication errors, user satisfaction and system acceptance, costs, care time and compliance with protocols.
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Antineoplásicos/uso terapêutico , Sistemas de Apoio a Decisões Clínicas , Atenção à Saúde/normas , Sistemas de Registro de Ordens Médicas , Erros de Medicação/prevenção & controle , Neoplasias/tratamento farmacológico , Prescrições/normas , Bases de Dados Factuais , Humanos , SoftwareRESUMO
Introduction and Objective: In most cases, due to the failure of nonsurgical methods in the treatment of diseases related to the colon, it is necessary to perform colostomy as the main treatment method. However, this surgery can cause a wide range of physical, social, and psychological problems in patients. Therefore, in order to prevent and treat the complications of colostomy, it is necessary to adopt measures in the field of self-care and continuous education for patients to control the complications of the disease, seek treatment, and experience improvements in their quality of life. Additionally, considering the role of mobile health (mHealth) applications in facilitating continuous and effective training, and improving self-care for these patients, the aim of the present study was to design and evaluate an mHealth application for self-care of colostomy patients. Materials and Methods: In the present applied research, first the functional requirements of the software were determined considering the self-care requirements of colostomy patients. Then, the software was designed based on object-oriented analysis, and according to it, the application was coded in Java and developed in the Android Studio environment. Finally, to evaluate the software, the opinions and comments of 5 gastroenterologists and 10 adult colostomy patients in the age range between 27 and 64 years who had at least a high school diploma were used as the basis of judgment at this stage. The instruments used in the evaluation included a checklist, derived from three standard questionnaires (the System Usability Scale [SUS], the mHealth App Usability Questionnaire [MAUQ], and the User Version of the Mobile Application Rating Scale [uMARS]) to measure the user-friendliness indicator, and a researcher-made checklist to measure the performance indicator of the various services provided. Results The services of the software developed include the provision of medical information and self-care instructions regarding colostomy surgery, as well as alerts for the user to schedule an appointment with a doctor and the time to take medications. Based on the results of the evaluation stage, the users were generally satisfied with the interface, services, and general features of the software. In general, the software was evaluated at the "acceptable" level, with a rate of 85%. Discussion and Conclusion Based on the findings of the current research, thesoftware developed can be significantly effective in facilitating the education of colostomy patients and improving their self-care. Proper and continuous self-care and education for colostomy patients is necessary to prevent and control complications resulting from surgery and to improve their quality of life. Therefore, in addition to patients, all health care staff, organizations, and associations which support colostomy patients can also use this software to educate patients and improve the care provided to them. (AU)