A systematic literature review on unnecessary diagnostic testing: The role of ICT use.

BACKGROUND: The negative impact of unnecessary diagnostic tests on healthcare systems and patients has been widely recognized. Medical researchers in various countries have been devoting effort to reduce unnecessary diagnostic tests by using different types of interventions, including information and communications technology-based (ICT-based) intervention, educational intervention, audit and feedback, the introduction of guidelines or protocols, and the reward and punishment of staff. We conducted a review of ICT based interventions and a comparative analysis of their relative effectiveness in reducing unnecessary tests. METHOD: A systematic Boolean search in PubMed, EMBase and EBSCOhost research databases was performed. Keyword search and citation analysis were also conducted. Empirical studies reporting ICT based interventions, and their implications on relative effectiveness in reducing unnecessary diagnostic tests (pathology tests or medical imaging) were evaluated independently by two reviewers based on a rigorously developed coding protocol. RESULTS: 92 research articles from peer-reviewed journals were identified as eligible. 47 studies involved a single-method intervention and 45 involved multi-method interventions. Regardless of the number of interventions involved in the studies, ICT-based interventions were utilized by 71 studies and 59 of them were shown to be effective in reducing unnecessary testing. A clinical decision support (CDS) tool appeared to be the most adopted ICT approach, with 46 out of 71 studies using CDS tools. The CDS tool showed effectiveness in reducing test volume in 38 studies and reducing cost in 24 studies. CONCLUSIONS: This review investigated five frequently utilized intervention methods, ICT-based, education, introduction of guidelines or protocols, audit and feedback, and reward and punishment. It provides in-depth analysis of the efficacy of different types of interventions and sheds insights about the benefits of ICT based interventions, especially those utilising CDS tools, to reduce unnecessary diagnostic testing. The replicability of the studies is limited due to the heterogeneity of the studies in terms of context, study design, and targeted types of tests.

The effectiveness of various robotic technologies in assisting older adults.

There is concern about the expanding size of the ageing population and burgeoning care costs for older adults. Robotic technology could assist older adults. In this study, the effectiveness of the robotic technologies is evaluated. A systematic literature review was undertaken of peer-reviewed literature. An initial set of 8533 studies was evaluated for relevance; these were reduced to a final subset of 58 studies finally subjected to analysis. This study categorised the problems encountered by older adults, identified robot types deployed to overcome them and derived a subjective effectiveness score. The most used and most effective robots were companion robots followed by telepresence robots. The findings imply positive effects of robotic technologies in helping elderly people's problems. Although robotic technologies could bring some innovation into aged care, more research is needed to design and develop robots to be of assistance and support elderly in having an independent lifestyle.