Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 24.677
Filtrar
1.
BMJ Open ; 11(9): e047156, 2021 09 02.
Artigo em Inglês | MEDLINE | ID: mdl-34475157

RESUMO

OBJECTIVES: Characterise the health status of patients newly consulting an orthopaedic specialist across eight clinical subspecialties. DESIGN: Retrospective cohort. SETTING: 18 orthopaedic clinics, including 8 subspecialties (14 ambulatory and 4 hospital based) within an academic health system. PARTICIPANTS: 14 910 patients consulting an orthopaedic specialist for a new patient consultation who completed baseline Patient-Reported Outcomes Measurement Information System (PROMIS) measures associated with their appointment from 17 November 2017 to 13 May 2019. Patients were aged 55.72±5.8 years old, and 61.3% were female and 79.3% were Caucasian and 13.4% were black or African American. Patients who did not complete PROMIS measures or cancelled their appointment were excluded from the study. PRIMARY OUTCOME: PROMIS domains of physical function, pain interference, pain intensity, depression, anxiety, fatigue, sleep disturbance and the ability to participate in social roles. RESULTS: Mean PROMIS scores for physical function were (38.1±9.2), pain interference (58.9±8.1), pain intensity (4.6±2.5), depression (47.9±8.9), anxiety (49.9±9.5), fatigue (50.5±10.3), sleep disturbance (51.1±9.8) and ability to participate in social roles (49.1±10.3) for the entire cohort. Across the clinical subspecialties, neurosurgery, spine and trauma patients were most profoundly affected across almost all domains and patients consulting with a hand specialist reported the least limitations or symptoms across domains. There was a moderate, negative correlation between pain interference and physical functioning (r=-0.59) and low correlations between pain interference with anxiety (r=0.36), depression (r=0.39) as well as physical function and anxiety (r=-0.32) and depression(r=-0.30) and sleep (r=-0.31). CONCLUSIONS: We directly compared clinically meaningful PROMIS domains across eight orthopaedic subspecialties, which would not have been possible with legacy measures alone. These results support PROMIS's utility as a common metric to assess and compare patient health status across multiple orthopaedic subspecialties.


Assuntos
Ortopedia , Depressão/diagnóstico , Depressão/epidemiologia , Feminino , Nível de Saúde , Humanos , Sistemas de Informação , Pessoa de Meia-Idade , Medidas de Resultados Relatados pelo Paciente , Estudos Retrospectivos
2.
Yearb Med Inform ; 30(1): 134-140, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34479385

RESUMO

OBJECTIVE: In this synopsis, we give an overview of recent research and propose a selection of best papers published in 2020 in the field of Clinical Information Systems (CIS). METHOD: As CIS section editors, we annually apply a systematic process to retrieve articles for the International Medical Informatics Association Yearbook of Medical Informatics. For seven years now, we use the same query to find relevant publications in the CIS field. Each year we retrieve more than 2,400 papers which we categorize in a multi-pass review to distill a preselection of 15 candidate papers. External reviewers and yearbook editors then assess the selected candidate papers. Based on the review results, the IMIA Yearbook editorial board chooses up to four best publications for the section at a selection meeting. To get an overview of the content of the retrieved articles, we use text mining and term co-occurrence mapping techniques. RESULTS: We carried out the query in mid-January 2021 and retrieved a deduplicated result set of 2,787 articles from 1,135 different journals. We nominated 15 papers as candidates and finally selected four of them as the best papers in the CIS section. As in the previous years, the content analysis of the articles revealed the broad spectrum of topics covered by CIS research. Thus, this year we could observe a significant impact of COVID-19 on CIS research. CONCLUSIONS: The trends in CIS research, as seen in recent years, continue to be observable. What was very visible was the impact of the Corona Virus Disease 2019 (COVID-19) pandemic, which has affected not only our lives but also CIS.


Assuntos
COVID-19 , Sistemas de Informação , Pesquisa Biomédica , Sistemas de Informação em Saúde , Humanos , Informática Médica
3.
Yearb Med Inform ; 30(1): 105-125, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34479384

RESUMO

OBJECTIVE: The year 2020 was predominated by the coronavirus disease 2019 (COVID-19) pandemic. The objective of this article is to review the areas in which clinical information systems (CIS) can be and have been utilized to support and enhance the response of healthcare systems to pandemics, focusing on COVID-19. METHODS: PubMed/MEDLINE, Google Scholar, the tables of contents of major informatics journals, and the bibliographies of articles were searched for studies pertaining to CIS, pandemics, and COVID-19 through October 2020. The most informative and detailed studies were highlighted, while many others were referenced. RESULTS: CIS were heavily relied upon by health systems and governmental agencies worldwide in response to COVID-19. Technology-based screening tools were developed to assist rapid case identification and appropriate triaging. Clinical care was supported by utilizing the electronic health record (EHR) to onboard frontline providers to new protocols, offer clinical decision support, and improve systems for diagnostic testing. Telehealth became the most rapidly adopted medical trend in recent history and an essential strategy for allowing safe and effective access to medical care. Artificial intelligence and machine learning algorithms were developed to enhance screening, diagnostic imaging, and predictive analytics - though evidence of improved outcomes remains limited. Geographic information systems and big data enabled real-time dashboards vital for epidemic monitoring, hospital preparedness strategies, and health policy decision making. Digital contact tracing systems were implemented to assist a labor-intensive task with the aim of curbing transmission. Large scale data sharing, effective health information exchange, and interoperability of EHRs remain challenges for the informatics community with immense clinical and academic potential. CIS must be used in combination with engaged stakeholders and operational change management in order to meaningfully improve patient outcomes. CONCLUSION: Managing a pandemic requires widespread, timely, and effective distribution of reliable information. In the past year, CIS and informaticists made prominent and influential contributions in the global response to the COVID-19 pandemic.


Assuntos
COVID-19 , Sistemas de Informação , Informática Médica , Telemedicina , Inteligência Artificial , COVID-19/diagnóstico , Teste para COVID-19 , Busca de Comunicante , Sistemas de Apoio a Decisões Clínicas , Registros Eletrônicos de Saúde , Epidemias , Troca de Informação em Saúde , Interoperabilidade da Informação em Saúde , Humanos , Disseminação de Informação
4.
Caja de Herramientas: Transformación DigitalOPS/EIH/IS/21-022.
Monografia em Espanhol | PAHO-IRIS | ID: phr-54805

RESUMO

La carga de trabajo que conlleva el proceso de documentación clínica, las dificultades en el uso de diferentes aplicaciones y los errores comunes derivados de la falta de información completa son problemas cada vez más frecuentes. Sin embargo, a pesar de los grandes avances en el campo de las tecnologías de la información y las comunicación y en la ciencia de datos, no se han registrado grandes cambios respecto del proceso general de documentación en el ámbito de la salud. En esta cápsula de conocimiento se aborda el camino hacia procesos más maduros y eficaces de documentación. Definir los roles, las funciones y las responsabilidades de los actores y autores; comprender y adaptar los flujos de trabajo, e implementar herramientas de soporte en la historia clínica electrónica que faciliten la tarea son intervenciones fundamentales para garantizar la disponibilidad de datos de calidad.


Assuntos
Sistemas de Informação , Sistemas de Informação em Saúde , Telemedicina , Estágio Clínico , Sistemas de Apoio a Decisões Clínicas , Telemedicina , América
5.
Caja de Herramientas: Transformación DigitalOPS/EIH/IS/21-023.
Não convencional em Espanhol | PAHO-IRIS | ID: phr-54797

RESUMO

Gestionar datos es, en la actualidad, un requisito básico para disponer de pruebas que fundamenten la toma de decisiones en el ámbito de la salud. Por tanto, es necesario diseñar estrategias que dominen el léxico especializado para que la información clínica almacenada en los sistemas informáticos pueda ser utilizada con múltiples propósitos, lo cual se logra mediante la representación de los datos de salud. En esta cápsula de conocimiento se explican este y otros conceptos, así como la inmportancia de las herramientas de codificación de términos y su relación con la transformación difital de la salud pública.


Assuntos
Sistemas de Informação , Sistemas de Informação em Saúde , Telemedicina , América
6.
Comput Intell Neurosci ; 2021: 9984003, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34539775

RESUMO

Tourism safety is the focus of the tourism industry. It is not only related to the safety of tourists' lives and property, but also related to social stability and sustainable development of the tourism industry. However, the security early warning of many scenic spots focuses on the response measures and remedial plans after the occurrence of security incidents, and the staff of many scenic spots have limited security awareness and information analysis ability, which is prone to lag in information release, and do not pay attention to the information of potential security problems. Therefore, this paper studies the optimization algorithm of the tourism security early warning information system based on the LSTM model and uses the recurrent neural network and LSTM to improve the processing and prediction ability of time-series data. The experimental results show that the number of three hidden layers in the tourism security early warning information system based on the LSTM model can reduce the training time of the model and improve the performance. Compared with the tourism safety early warning information system based on the BP neural network, it has better accuracy and stability, has better processing and prediction ability for time series data, and can monitor and analyze data scientifically in real-time and dynamically analyze data.


Assuntos
Memória de Curto Prazo , Turismo , Algoritmos , Humanos , Sistemas de Informação , Redes Neurais de Computação
7.
Int J Med Inform ; 153: 104529, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-34385097

RESUMO

OBJECTIVE: The widespread and frequent use of mobile technology among adolescents, including sexual minority adolescents, presents an opportunity for the development of mobile health (mHealth) technology to combat the continuing HIV epidemic among young men who have sex with men (YMSM). We analyzed perceptions of the quality and impact of an HIV prevention mobile app on sexual risk reduction among YMSM. METHODS: Participants were recruited from a larger randomized controlled trial of the MyPEEPS Mobile app among YMSM aged 13-18 years. Data were collected via semi-structured interviews to assess quality and user satisfaction with MyPEEPS Mobile app using analysis informed by the Information Systems Success framework. Interview data were transcribed verbatim and analyzed using six themes: information quality, net benefit, user satisfaction, product quality, service quality, and health care barriers. RESULTS: Interviews were conducted with 40 YMSM (45% Hispanic; 80% non-White; 88% non-rural resident; 28% aged 17 years). Participants' responses indicated that information quality was high, reporting that the app information was concise, easy to understand, useful, and relevant to their life. The net benefits were stated as improvements in their decision-making skills, health behaviors, communication skills with partner(s), and increased knowledge of HIV risk. There was general user satisfaction and enjoyment when using the app, although most of the participants did not intend to reuse the app unless new activities were added. Participants expressed that the product quality of the app was good due to its personalization, representation of the LGBTQIA + community, and user-friendly interface. Although no major technical issues were reported, participants suggested that adaption to a native app, rather than a web app, would improve service quality through faster loading speed. Participants also identified some health care barriers that were minimized by app use. CONCLUSIONS: The MyPEEPS Mobile app is a well received, functional, and entertaining mHealth HIV prevention tool that may improve HIV prevention skills and reduce HIV risk among YMSM.


Assuntos
Infecções por HIV , Aplicativos Móveis , Saúde Sexual , Minorias Sexuais e de Gênero , Adolescente , Infecções por HIV/prevenção & controle , Homossexualidade Masculina , Humanos , Sistemas de Informação , Masculino
8.
Rev Bras Epidemiol ; 24: e210045, 2021.
Artigo em Português, Inglês | MEDLINE | ID: mdl-34406207

RESUMO

OBJECTIVE: To assess the impact of 2008 Public Law number 11,705, also known as Dry Law (DL-08), on mortality from road traffic accidents (RTA), in each of the 27 Brazilian Federative Units (BFUs). METHODS: Ecological study of interrupted time series with RTA data from 2002 to 2015, totalizing 168 months. Data were obtained from the Mortality Information System, the Brazilian Institute of Geography and Statistics, and from the National Traffic Department. Autoregressive integrated moving average (ARIMA) models were adjusted to assess the impact of DL-08 in each BFUs. RESULTS: After the implementation of the DL-08, there was a significant decrease in mortality from RTA in the state of Santa Catarina (pre DL-08 = 2.60 ± 0.30 and post DL-08 = 2.32 ± 0.35; p < 0.001) and in the Federal District (pre DL-08 = 2.22 ± 0.40 and post DL-08 = 1.76 ± 0.35; p = 0.002), a significant increase in mortality in the states of Acre, Amazonas, Rondônia, Maranhão, Piauí, Ceará, Rio Grande do Norte, Paraíba, Pernambuco, Alagoas, Sergipe and Mato Grosso, and a stability in the other states. The sensitivity analysis conducted over a shorter time series with 24 months showed results similar to those obtained with the 168-month series for most of the 27 BFUs. CONCLUSION: The DL-08 had a heterogeneous impact on mortality from traffic accidents on BFUs.


Assuntos
Acidentes de Trânsito , Sistemas de Informação , Brasil/epidemiologia , Geografia , Humanos , Análise de Séries Temporais Interrompida
9.
Comput Intell Neurosci ; 2021: 6046757, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34456994

RESUMO

With the deepening of big data and the development of information technology, the country, enterprises, organizations, and even individuals are more and more dependent on the information system. In recent years, all kinds of network attacks emerge in an endless stream, and the losses are immeasurable. Therefore, the protection of information system security is a problem that needs to be paid attention to in the new situation. The existing BP neural network algorithm is improved as the core algorithm of the security intelligent evaluation of the rating information system. The input nodes are optimized. In the risk factor identification stage, most redundant information is filtered out and the core factors are extracted. In the risk establishment stage, the particle swarm optimization algorithm is used to optimize the initial network parameters of BP neural network algorithm to overcome the dependence of the network on the initial threshold, At the same time, the performance of the improved algorithm is verified by simulation experiments. The experimental results show that compared with the traditional BP algorithm, PSO-BP algorithm has faster convergence speed and higher accuracy in risk value prediction. The error value of PSO-BP evaluation method is almost zero, and there is no error fluctuation in 100 sample tests. The maximum error value is only 0.34 and the average error value is 0.21, which proves that PSO-BP algorithm has excellent performance.


Assuntos
Algoritmos , Redes Neurais de Computação , Simulação por Computador , Humanos , Sistemas de Informação
10.
J Pediatr Orthop ; 41(9): e727-e732, 2021 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-34369473

RESUMO

BACKGROUND: Arthrogryposis multiplex congenita (AMC) is a clinical term that is used to describe congenital contractures that lead to childhood deformities. Treatment aims are to maximize function while minimizing pain and disability. Few studies have explored patient-reported outcomes in the pediatric arthrogrypotic population, particularly concerning mobility. The aim of this study was to report scores for the Patient-Reported Outcome Measurement Information System (PROMIS) questionnaire for pediatric patients with arthrogryposis with regards to mobility, upper extremity (UE) function, pain interference, and peer relationships. METHODS: A retrospective chart review of 76 patients with AMC aged 5 to 17 who completed the PROMIS questionnaire between January 1, 2017 to March 24, 2020 was performed. Results were collected for four domains: mobility, UE function, pain interference, and peer relationships. Outcomes were stratified by type of arthrogryposis: Amyoplasia (Am), Distal Arthrogryposis (DA), and Other Diagnoses (OD). Results of subjects with isolated upper or lower extremity involvement were compared with subjects with involvement of upper and/or lower extremities. Outcomes were correlated with history of surgical intervention. RESULTS: Children with Am and OD demonstrated moderate impairment of mobility (average: 35.2 and 35.9, respectively), while those with DA reported only mild impairment (average: 44.9). UE function was severely impaired for children with Am (average: 23.0), moderately impaired for OD (average: 33.0), and mildly impaired for DA (average: 43.4). All patient groups reported normal ranges of pain interference, as well as good peer relationships. A moderate negative correlation between number of surgical interventions and mobility scores, and a weak negative correlation between number of surgeries and pain interference scores were found. CONCLUSIONS: Children with AMC experience limited mobility and UE function, but normal levels of pain interference and good peer relationships. The average values provided in this study will serve as a baseline from which to evaluate the efficacy of both nonoperative and surgical interventions. LEVEL OF EVIDENCE: Level II-prognostic study; retrospective study.


Assuntos
Artrogripose , Artrogripose/diagnóstico , Criança , Humanos , Sistemas de Informação , Medidas de Resultados Relatados pelo Paciente , Estudos Retrospectivos , Extremidade Superior
11.
Rev Esc Enferm USP ; 55: e20200538, 2021.
Artigo em Inglês, Português | MEDLINE | ID: mdl-34464433

RESUMO

OBJECTIVE: To analyze the spatiality of completeness of the Information System on Diseases of Compulsory Declaration of tuberculosis in Paraná state, focusing on the border region. METHOD: A study composed by the notified cases of the disease treated in Paraná between 2008 and 2017. The variable completeness was classified as excellent (<5% of incompleteness), good (5 to <10%), regular (10 to <20%), poor (20% to 50%), and very poor (>50%). Moran global was used for the spatial correlation and local association was analyzed. Logistic regression was employed to assess the spatial association of the variables with the border and, for the significant variables, multiple logistic regression was used. The study abides by the resolution 510/2016 of the National Health Council. RESULTS: There was a "high-high" correlation for education level, 2- and 6-month sputum smear in the Eastern health macroregional and "high-high" correlation in the Northwestern macroregional for 2-month sputum smear and antibiotic sensitivity testing. There was no spatial association with the border. CONCLUSION: Unsatisfactory completeness was identified in the database and conglomerates, indicating spatial association of incompleteness of some variables, but with no relation with the border. There was no worsening of completeness nor of the case outcomes related to these regions.


Assuntos
Tuberculose , Brasil/epidemiologia , Bases de Dados Factuais , Humanos , Sistemas de Informação , Análise Espacial , Tuberculose/epidemiologia
12.
BMC Public Health ; 21(1): 1338, 2021 07 07.
Artigo em Inglês | MEDLINE | ID: mdl-34229643

RESUMO

OBJECTIVE: Adverse events following immunization is an important factor influencing public trust in vaccination. Publicizing its incidence timely can increase public trust. The aim of this study is to describe the incidence and characteristics of adverse events following immunization in Jiangsu province of China from 2015 to 2018. METHODS: All information of adverse events following immunization (AEFIs) was gained from Jiangsu Province Vaccination Integrated Service Management Information System. The reported AEFI trend was analyzed using Chi-square test. RESULTS: A total of 77,980 AEFI cases were reported through the AEFI system; Among which, 77,731 were classified as non-serious AEFI cases and 249 were serious AEFI cases. The male to female ratio was 1.31:1, cases less than 7 years old accounted for 97.7%. The total estimated AEFI rate was 62.70/100,000 doses. By severity, 60.75/100,000, 4.46/100,000 and 0.11/100,000 AEFI cases were common vaccine reaction, rare vaccine reaction, and serious rare vaccine reaction, respectively. The top two serious AEFI were thrombocytopenic purpura and febrile. The incidence rates showed the increasing trend and the linear trend of the increasing incidence rates passed the significant test at 0.05 levels. CONCLUSION: The sensitivity of AEFI monitoring in Jiangsu Province is increasing and higher than the national average and most countries. The majority of AEFI cases were common adverse reactions, while the serious vaccine reactions caused by vaccines were extremely low. To elevate the sensitivity of AEFI surveillance may reduce the incidence of developing serious AEFI cases.


Assuntos
Imunização , Vacinas , Sistemas de Notificação de Reações Adversas a Medicamentos , Criança , China/epidemiologia , Feminino , Humanos , Lactente , Sistemas de Informação , Masculino , Vacinação , Vacinas/efeitos adversos
13.
J Med Syst ; 45(8): 77, 2021 Jul 02.
Artigo em Inglês | MEDLINE | ID: mdl-34213620

RESUMO

Upgraded network technology presents an advanced technological platform for telecare medicine information systems (TMIS) for patients. However, TMIS generally suffers various attacks since the information being shared through the insecure channel. Recently, many authentication techniques have been proposed relying on the chaotic map. However, many of these designs are not secure against the known attacks. In spite of the fact that some of the constructions attain low computation overhead, they cannot establish an anonymous communication and many of them fail to ensure forward secrecy. In this work, our aim is to present authentication and key agreement protocol for TMIS utilizing a chaotic map to achieve both security and efficiency. The underlying security assumptions are chaotic theory assumptions. This scheme supports forward secrecy and a secure session is established with just two messages of exchange. Moreover, we present a comparative analysis of related authentication techniques.


Assuntos
Segurança Computacional , Telemedicina , Confidencialidade , Humanos , Sistemas de Informação
14.
Arthroscopy ; 37(7): 2279-2280, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-34226014

RESUMO

In today's health care climate, the patient perspective is becoming increasingly important. As the health care paradigm shifts toward value-based health care, patient-reported outcomes are becoming increasingly important for not only research but for routine clinical care. While there are many outcome instruments used for musculoskeletal care, the addition of the simple question of "how are you doing" or "are your symptoms manageable" can provide additional valuable insight to the provider and help improve care using a shared decision model. In other words, if you want to know how the patient is doing, you have to ask them. This biopsychosocial approach demonstrates caring for the entire patient. The Patient-Reported Outcomes Measurement Information System (PROMIS) is a patient-reported outcome instrument that was developed using the biopsychosocial model and has the advantage of being administered as a computer adaptive test. It can be used across health care and is comparable across medical specialties as the scores are standardized to US population-based norms. When used in isolation, PROMIS provides an idea of how the patient is doing compared with the population but does not give the insight as to how the patient is coping with their condition. The addition of an anchor question, such as their patient acceptable symptom state, adds further understanding to the individual patient.


Assuntos
Ortopedia , Humanos , Sistemas de Informação , Dor , Medidas de Resultados Relatados pelo Paciente
15.
Sensors (Basel) ; 21(13)2021 Jul 04.
Artigo em Inglês | MEDLINE | ID: mdl-34283138

RESUMO

OBJECTIVE: The purpose of this study was to verify changes in a driver's emotions through the physical characteristics of haptic signals. This is to improve the performance of drivers by designing haptic signals with emotional semantics. BACKGROUND: Currently, drivers receive a variety of information through intelligent systems installed in their vehicles. Because this is mainly achieved through visual and auditory channels, an excessive amount of information is provided to drivers, which increases the amount of information and cognitive load that they must accept. This, in turn, can reduce driving safety. It is, therefore, necessary to develop a haptic signal, a sensory channel that has not been widely used in in-vehicle information systems. METHODS: The experiment was performed to collect a driver's emotions according to the haptic signal in a driving simulator. Haptic signals were designed by various frequencies and accelerations, and driver emotions were collected through Kansei engineering techniques and analyzed through factor analysis. To verify intelligibility, haptic signals were compared and evaluated based on response time, response rate, and amount of transmitted information. RESULTS: The final determined emotional map consisted of dangerousness and urgency. Based on the emotional map, four emotional semantic haptic signals were designed. It was confirmed that these four signals displayed higher performance than the discriminability haptic signal in terms of response time, response rate, and amount of transmitted information. CONCLUSIONS: Using emotional maps, it is possible to design haptic signals that can be applied to various driving situations. These maps may also assist in securing design guidelines for haptic signals that apply to in-vehicle information systems.


Assuntos
Condução de Veículo , Aceleração , Acidentes de Trânsito , Cognição , Sistemas de Informação , Tempo de Reação
16.
Sensors (Basel) ; 21(13)2021 Jul 05.
Artigo em Inglês | MEDLINE | ID: mdl-34283155

RESUMO

Automatic Dependent Surveillance-Broadcast (ADS-B) is the main communication system currently being used in Air Traffic Control (ATC) around the world. The ADS-B system is planned to be a key component of the Federal Aviation Administration (FAA) NextGen plan, which will manage the increasingly congested airspace in the coming decades. While the benefits of ADS-B are widely known, its lack of security measures and its vulnerability to cyberattacks such as jamming and spoofing is a great concern for flight safety experts. In this paper, we first summarize the cyberattacks and challenges related to ADS-B's vulnerabilities. Thereafter, we present theoretical and practical methods for implementing an Internet of Things (IoT)-based system as a possible additional safety layer to mitigate the presented cyber-vulnerabilities. Finally, a set of simulations and field experiments is presented to test the expected performance of the suggested IoT flight safety system. We conjecture that the presented system can be implemented in a wide range of civilian airplanes, leading to an improvement in flight safety in cases of cyberattacks or the absence of reliable ADS-B communication.


Assuntos
Internet das Coisas , Comunicação , Sistemas de Informação
18.
Int J Med Inform ; 152: 104459, 2021 08.
Artigo em Inglês | MEDLINE | ID: mdl-34091145

RESUMO

BACKGROUND AND OBJECTIVE: The user interface usability of the nursing information system (NIS) should be such that the nurses can learn and interact with it easily and quickly. Therefore, it is necessary to identify and solve the usability problems of these systems. The present study aimed to evaluate the usability of a NIS using the cognitive walkthrough (CW) evaluation method. METHODS: Based on five selected scenarios, five evaluators evaluated the NIS in Shafa Hospital Information System. After identifying the problems, the evaluators assigned each problem to one of the usability attributes. The severity of each identified problem was determined by the evaluators and five real users of the system. RESULTS: In total, 24 unique problems were identified. The average severity of the problems was determined by the evaluators (2.77) and the actual users (2.82) in the "major problem" category. The highest number of problems were assigned to the scenarios 3 and 2 with 15 and 14 problems, respectively. The highest average severity in terms of evaluations and actual users was related to the scenario 5 (3.06 and 2.94, respectively), which was in the "major problem" category. The highest number of problems were associated with learnability (8 problems) and efficiency (6 problems). CONCLUSION: Since most of the nurses do not have enough time for learning the system, and given that the selected scenarios for evaluation were based on the most frequent daily tasks that nurses performed using the NIS; The correction of usability problems in the scenarios 3 and 2 that had the highest number of problems and the scenario 5 that had the highest average severity and execution time; it can reduce the nurses' cognitive load and the learning time of the system and increase the efficiency of nurses.


Assuntos
Sistemas de Informação Hospitalar , Interface Usuário-Computador , Cognição , Sistemas Computacionais , Humanos , Sistemas de Informação
19.
Am J Sports Med ; 49(9): 2457-2465, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-34097552

RESUMO

BACKGROUND: Although minimal clinically important difference (MCID), Patient Acceptable Symptom State (PASS), and substantial clinical benefit (SCB) have been defined for hip-specific legacy patient-reported outcome measures, these metrics have not been defined for the Patient-Reported Outcomes Measurement Information System (PROMIS) instruments for patients undergoing hip arthroscopy. PURPOSE: To define the MCID, PASS, and SCB thresholds for the PROMIS Physical Function (PF) computerized adaptive test (CAT) and PROMIS Pain Interference (PI) instruments in patients undergoing hip arthroscopy for femoroacetabular impingement syndrome (FAIS). STUDY DESIGN: Cohort study (Diagnosis); Level of evidence, 2. METHODS: Patients undergoing primary hip arthroscopy between August 2018 and January 2019 for the treatment of FAIS were retrospectively analyzed. Patients were administered the PROMIS-PF, PROMIS-PI, Hip Outcome Score (HOS)-Activities of Daily Living, HOS-Sports Subscale, modified Harris Hip Score, and International Hip Outcome Tool-12 preoperatively and at 1 year postoperatively. MCID was calculated using the distribution method, whereas PASS and SCB were calculated using an anchor-based method. Patients achieving clinically significant outcomes (CSOs) were compared with those who did not achieve CSOs via chi-square and independent-samples t tests, and a multivariate logistic regression was conducted to determine predictors of CSO achievement. RESULTS: 124 patients with a mean age of 32.7 ± 12.3 years were included in the analysis. The threshold scores required to achieve MCID, PASS, and SCB, respectively, were as follows: PROMIS-PI (-3.1, 53.7, 51.9) and PROMIS-PF (3.3, 47.0, 49.9). Patients achieved any MCID, PASS, and SCB for PROMIS scores at a rate of 89.0%, 71.8%, and 62.1%, respectively, compared with 87.1%, 76.6%, and 71.8% for legacy patient-reported outcome measurements. For PROMIS-PF, higher preoperative PROMIS-PF score was a positive predictor of CSO achievement, and patients achieving SCB were significantly younger (30.3 ± 12 vs 35.6 ± 12 years; P = .017) with significantly lower body mass index (BMI) (24.7 ± 6.4 vs 27.9 ± 7; P = .009). Preoperative chronic pain and history of orthopaedic surgery were negative predictors of PROMIS-PI CSO achievement, whereas higher (worse) preoperative PROMIS-PI scores were a positive predictor. CONCLUSION: Our study defined the MCID, PASS, and SCB for the PROMIS-PF CAT and PROMIS-PI CAT at 1 year postoperatively. Patients with higher preoperative PROMIS scores, younger age, and lower BMI were more likely to achieve CSO, whereas preoperative chronic pain and history of orthopaedic surgery were negative predictors of CSO achievement.


Assuntos
Impacto Femoroacetabular , Atividades Cotidianas , Artroscopia , Estudos de Coortes , Impacto Femoroacetabular/cirurgia , Seguimentos , Articulação do Quadril/cirurgia , Humanos , Sistemas de Informação , Diferença Mínima Clinicamente Importante , Medidas de Resultados Relatados pelo Paciente , Estudos Retrospectivos , Resultado do Tratamento
20.
Clin J Pain ; 37(9): 639-647, 2021 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-34183533

RESUMO

OBJECTIVE: Musculoskeletal pain is a significant contributor to the global disease burden. Management of musculoskeletal pain where a neuropathic component is present can be challenging. This study evaluated the internal structure of the Patient-Reported Outcome Measures Information System (PROMIS) pain quality scales, explored the prevalence of neuropathic and nociceptive pain, and identified health demographics and behaviors related to musculoskeletal pain presentations. METHODS: Patients presenting to the Victoria University Osteopathy Clinic (Melbourne, Vic., Australia) were invited to complete a health demographics and behaviors questionnaire, and the PROMIS Neuropathic (NeuroPQ) and Nociceptive (NociPQ) pain quality scales, before their initial consultation. Descriptive, inferential, and correlation statistics were used to evaluate the PROMIS scales, health demographics, and behaviors. Mokken scale analysis was used to evaluate the internal structure and dimensionality of the NeuroPQ and NociPQ scales. RESULTS: Three hundred eighty-three (N=383) patients completed the measures. Mokken scaling suggested the PROMIS scales demonstrated acceptable internal structure and were unidimensional. Over 22% of patients demonstrated cutoff scores above 50, suggesting a substantive neuropathic pain component to their musculoskeletal presentation. Patients who reported cigarette smoking, not being born in Australia or not speaking English at home, demonstrated higher NeuroPQ scores. Females demonstrated significantly higher NociPQ scores than males. Pain intensity demonstrated small to medium correlations with NeuroPQ and NociPQ scores. DISCUSSION: This study provides support for the use of the NeuroPQ and NociPQ scales in musculoskeletal pain patients. Associations with health demographics and behaviors were identified, and patients typically experienced a combination of neuropathic and nociceptive pain.


Assuntos
Dor Musculoesquelética , Dor Nociceptiva , Feminino , Humanos , Sistemas de Informação , Masculino , Dor Musculoesquelética/epidemiologia , Dor Nociceptiva/epidemiologia , Medidas de Resultados Relatados pelo Paciente , Inquéritos e Questionários
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...