Connecting verified databases with clinical practice and the patient' s experience through omnichannel communication.

INTRODUCTION: Patient-reported outcomes (PRO) collect data directly from patients. These data are utilized in clinical practice, helping decision-making. Studies emphasize the importance of omnichannel communication (WhatsApp, e-mail, SMS) with healthcare professionals and patients. Omnichannel communication enables the integration of different communication channels to improve the end-client experience. In addition to the means of communication, the daily practice of professionals requires different activities that can be performed in distinct systems. The existence of various separate systems for other activities in medical practice may result in complexities and bottlenecks in their use by healthcare professionals and patients. OBJECTIVE: To present the Digital Health Ecosystem (DHE) that unifies scientific research with medical practice in omnichannel communication and mechanisms to verify the authenticity and integrity of the data collected and stored. METHODOLOGY: The system requirements and needs were met utilizing the Iconix development methodology. Microsoft Dot Net was used to develop software. Usability, usefulness and user satisfaction with the system were measured using the Post-Study System Usability Questionnaire (PSSUQ). RESULTS: Omnichannel communication was utilized to contact patients and healthcare professionals autonomously. A single system enabled the carrying out of patientreported outcome data collection, telemedicine, image storage, and notes from patient consultations. The data was collected through structured questionnaires via link and chatbot. The functionalities created in the HDE allowed the integrity and authenticity verification of the data collected and stored. CONCLUSION: Personalized omnichannel communication via links and chatbots using WhatsApp, E-mail, and SMS accelerates autonomous interaction with patients and healthcare professionals. In addition, the structured and non-structured data were stored in the EHD and able to be verified for integrity and authenticity.

Is Shoulder Imbalance a Useful Parameter in the Screening of Idiopathic Scoliosis? A Preliminary Study.

Objective The present study aims to analyze the use of shoulder imbalance as a parameter for scoliosis screening as well as its relationship with other parameters of physical examination. Methods This study assesses a smartphone application that analyzes several parameters of the physical examination in adolescent idiopathic scoliosis. Medical and non-medical examiners applied the screening tool in students in a public school and in a private sports club. After data collection, interobserver correlation was done to verify shoulder imbalance and to compare shoulder imbalance with Adam's bending test and with trunk rotation. Results Eighty-nine participants were examined, 18 of whom were women and 71 of whom were men. Two subjects were excluded from the analysis. The mean age of subjects from the public school was 11.30 years and, for those from the sports club, it was 11.92 years. The examiners had poor-to-slight interobserver concordance on shoulder asymmetry in the anterior and posterior view. No significant statistical correlation was found between shoulder asymmetry and positive Adam's forward bending test. Conclusion Our preliminary study shows that the shoulder asymmetry has a poor correlation with the Adam's forward bending test and measuring trunk rotation using a scoliometer. Therefore, the use of shoulder imbalance might not be useful for idiopathic scoliosis screening. Level of Evidence III; Diagnostic Study.

Is Shoulder Imbalance a Useful Parameter in the Screening of Idiopathic Scoliosis? A Preliminary Study / O desequilíbrio do ombro é um parâmetro útil na triagem da escoliose idiopática? Um estudo preliminar

Abstract Objective The present study aims to analyze the use of shoulder imbalance as a parameter for scoliosis screening as well as its relationship with other parameters of physical examination. Methods This study assesses a smartphone application that analyzes several parameters of the physical examination in adolescent idiopathic scoliosis. Medical and non-medical examiners applied the screening tool in students in a public school and in a private sports club. After data collection, interobserver correlation was done to verify shoulder imbalance and to compare shoulder imbalance with Adam's bending test and with trunk rotation. Results Eighty-nine participants were examined, 18 of whom were women and 71 of whom were men. Two subjects were excluded from the analysis. The mean age of subjects from the public school was 11.30 years and, for those from the sports club, it was 11.92 years. The examiners had poor-to-slight interobserver concordance on shoulder asymmetry in the anterior and posterior view. No significant statistical correlation was found between shoulder asymmetry and positive Adam's forward bending test. Conclusion Our preliminary study shows that the shoulder asymmetry has a poor correlation with the Adam's forward bending test and measuring trunk rotation using a scoliometer. Therefore, the use of shoulder imbalance might not be useful for idiopathic scoliosis screening. Level of Evidence III; Diagnostic Study

Resumo Objetivo O objetivo deste estudo é analisar o uso da assimetria de ombros como parâmetro para a triagem de escoliose e sua relação a outros parâmetros do exame físico. Métodos Este estudo avalia um aplicativo para smartphone que analisa diversos parâmetros do exame físico de adolescentes com escoliose idiopática. Examinadores médicos e não médicos utilizaram o instrumento de triagem em alunos de uma escola pública e de um clube esportivo privado. Após a coleta de dados, a correlação interobservador foi determinada para verificar a assimetria de ombros e compará-la ao teste de inclinação de Adam e à medição da rotação do tronco. Resultados Oitenta e nove participantes foram examinados, sendo 18 do sexo feminino e 71 do sexo masculino. Dois indivíduos foram excluídos da análise. A média de idade dos participantes da escola pública foi de 11,30 anos e do clube esportivo, 11,92 anos. Os examinadores apresentaram concordância interobservador baixa a branda quanto à assimetria de ombros em incidência anterior e posterior. Não houve correlação estatística significativa entre a assimetria de ombros e o resultado positivo no teste de inclinação do tronco de Adam. Conclusão Nosso estudo preliminar mostra que a assimetria de ombros tem baixa correlação com o teste de inclinação de Adam e assim como com a medição de rotação do tronco com escoliômetro. Portanto, o uso da assimetria de ombros pode não ser útil na triagem da escoliose idiopática. Nível de Evidência III; Estudo Diagnóstico

Multilanguage health record database focused on the active follow-up of patients and adaptable for patient-reported outcomes and clinical research design.

INTRODUCTION: A dataset with patient information allows a comparison between different clinical treatments in many fields of medicine as well as the effective use of medical resources. Patient-reported outcome measures (PROMs) collect data directly from patients for use in clinical practice by helping decision making and tailoring treatments according to the patients' needs. The authors present a novel database to overcome data collection related barriers, calculating automatically the questionnaire results, displayed in graphics on the patients' dashboard in real time, and focused on the active follow of the patients. OBJECTIVE: To present electronic health record database for monitoring clinical or surgical interventions and assess the usability. METHODOLOGY: Process modeling and specification of system requirements were performed using the Iconix methodology along with the Post-Study System Usability Questionnaire (PSSUQ) to validate the usability and usefulness of the proposed system. The system and the questionnaires were performed in three languages: Brazilian Portuguese, Spanish, and English. RESULTS: The database enables researchers to use the questionnaires defining the time of data collection according to the needs of each clinical study. The system facilitates the patient answers without any personal interference from smartphones, tablets or computers. The questionnaire scores were calculated automatically in real time and displayed in graphics on the patients' dashboard. The evaluation of the usability and usefulness of the developed database used 8 people divided into two equal groups (4 physicians and 4 medical students). CONCLUSION: The proposed electronic health record database allows a friendly and flexible use of PROMs according to the population, needs in practice and clinical settings. The platform promotes active and direct data collection from patients and physicians in English, Portuguese and Spanish.