interactive Journal of Medical Research

A general medical journal, focussing on innovation in health and medical research

Disease Risk Rule Analysis of the New Rural Cooperative Medical System

Background: With data drawn from Beijing’s New Rural Cooperative Medical System (NRCMS), the disease risk association rules of participating rural residents is studied in terms of risk factors and risk measures, and the rule characteristics of Beijing’s NRCMS disease risks are mined therefrom Objective: With data drawn from Beijing’s New Rural Cooperative Medical System (NRCMS), the disease risk association rules of participating rural residents is studied in terms of risk factors and risk measures, and the rule characteristics of Beijing’s NRCMS disease risks are mined therefrom Methods: The association rule algorithm is utilized to recover both potentially valuable knowledge and decision-making information from NRCMS data. Results: The main objects of healthcare in Beijing from 2012 to 2013 include: circulatory diseases in patients 41 years of age or older, pediatric respiratory disease prevention, reproductive health care for women of childbearing age, and the prevention and treatment of diabetes in female patients; in county-level hospitals with a relatively low average level of consumption, injuries still resulted in high expenses; the primary post-NRCMS reimbursement level-3 and level-4 high-risk groups were patients of 41-65 years of age. Conclusions: According to the ranking of rule supports, the highest support rule in Beijing is that of the circulatory diseases of middle-aged patients, especially patients that are hospitalized in county-level medical institutions; the second highest support comes from the utilization of fertility services for women of childbearing age.

2013-04-28

Interact J Med Res articles are indexed in PubMed (http://www.ncbi.nlm.nih.gov/pubmed/?term=Interact+J+Med_Res) and the full text is immediately deposited in PubMed Central (http://www.ncbi.nlm.nih.gov/pmc/journals/2065/). The Interact J Med Res adheres to the same quality standards as JMIR and all articles published here are also cross-listed in the Table of Contents of JMIR, the worlds' leading medical journal in health sciences / health services research and health informatics (http://www.jmir.org/issue/current).

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Journal Description

i-JMR is a new general medical journal, harnessing the power of the Internet and mobile platforms (iPad) for knowledge dissemination and translation.

i-JMR is a general medical journal with a focus on innovation in health, health care, and medicine - through new medical techniques and innovative ideas and/or research, including - but not limited to - technology, clinical informatics, or groundbreaking research.

Published by JMIR Publications, publisher of JMIR, the leading eHealth/mHealth journal (Impact Factor 2011: 4.4), i-JMR has a broader scope and features a rapid and thorough peer-review process, professional copyediting, professional production of PDF, XHTML, and XML proofs (ready for deposit in PubMed Central), and an ipad App (in prep.).

 

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  • Image courtesy of duron123 at FreeDigitalPhotos.net.

    Content and Quality of Information Websites About Congenital Heart Defects Following a Prenatal Diagnosis

    Abstract:

    Background: Pregnant women and their partners use the Internet to search for information following a prenatal diagnosis of congenital heart defect. Objective: Our aim was to explore central subjects of content and to assess the accessibility, reliability, usability, and quality of written information on publicly available information websites about congenital heart defects following a prenatal diagnosis. Methods: Following searches on Bing and Google, we included websites containing patient information in English. Hits ranged from 340,000-67,500,000 and the first 50 hits from each search were screened for inclusion (N=600). Of these hits, 39.3% (236/600) were irrelevant. A total of 67 websites were included, of which 37% (25/67) were affiliated with independent information websites, 25% (17/67) with charity/private organizations, 25% (17/67) with hospitals/clinics, and 13% (8/67) had other affiliations. The majority of the websites (76%, 51/67) could not be attributed to an author. A manifest content analysis was performed to explore central subjects of content. The DISCERN instrument was used to assess the quality of information, and the LIDA tool was used to assess accessibility, usability, and reliability of the included websites. Results: The content on the majority of the websites included care and treatment of children with congenital heart defects (88%, 59/67), causes of congenital heart defects (88%, 59/67), symptoms of congenital heart defects (85%, 57/67), prevalence of congenital heart defects (81%, 54/67), potential complications of congenital heart defects (75%, 50/67), prenatal diagnostics/screening methods (72%, 48/67), and specific congenital heart defects (72%, 48/67), whereas less than 10% included information about termination of pregnancy (6%, 4/67), care during pregnancy (5%, 3/67), and information specifically directed to partners (1%, 1/67). The mean of the total DISCERN score was 27.9 (SD 9.7, range 16-53). According to the instrument, a majority of the websites were categorized as very poor regarding information about effects of no treatment (88%, 59/67), support for shared decision making (85%, 57/67), achievement of its aims (84%, 56/67), explicit aims (82%, 55/67), risks of each treatment (82%, 55/67), how treatment choices affect overall quality of life (76%, 51/67), and areas of uncertainty (76%, 51/67). The mean of the total LIDA score was 92.3 (SD 13.1, range 61-127). According to the tool, a majority of the websites were categorized as good with regard to registration (97%, 65/67) and browser test (75%, 50/67), whereas a majority were categorized as poor with regard to currency (87%, 58/67), content production (84%, 56/67), and engagability (75%, 50/67). Conclusions: Difficulties in finding relevant information sources using Web search engines and quality deficits on websites are an incentive for health professionals to take an active part in providing adequate and reliable information online about congenital heart defects.

  • Screenshot of YouTube 'sedentary lifestyle' page.

    Information Seeking in Social Media: A Review of YouTube for Sedentary Behavior Content

    Abstract:

    Background: The global prevalence of sedentary lifestyles is of grave concern for public health around the world. Moreover, the health risk of sedentary behaviors is of growing interest for researchers, clinicians, and the general public as evidence demonstrates that prolonged amounts of sedentary time increases risk for lifestyle-related diseases. There is a growing trend in the literature that reports how social media can facilitate knowledge sharing and collaboration. Social sites like YouTube facilitate the sharing of media content between users. Objective: The purpose of this project was to identify sedentary behavior content on YouTube and describe features of this content that may impact the effectiveness of YouTube for knowledge translation. Methods: YouTube was searched on a single day by 3 independent reviewers for evidence-based sedentary behavior content. Subjective data (eg, video purpose, source, and activity type portrayed) and objective data (eg, number of views, comments, shares, and length of the video) were collected from video. Results: In total, 106 videos met inclusion criteria. Videos were uploaded from 13 countries around the globe (ie, Australia, Barbados, Belgium, Canada, Colombia, Kenya, New Zealand, Russia, South Africa, Spain, Ukraine, United Kingdom, United States). The median video length was 3:00 minutes: interquartile range (IQR) 1:44-5:40. On average, videos had been on YouTube for 15.0 months (IQR 6.0-27.5) and had been viewed 239.0 times (IQR 44.5-917.5). Videos had remarkably low numbers of shares (median 0) and comments (median 1). Only 37.7% (40/106) of videos portrayed content on sedentary behaviors, while the remaining 66 videos portrayed physical activity or a mix of behaviors. Academic/health organizations (39.6%, 42/106) and individuals (38.7%, 41/106) were the most prevalent source of videos, and most videos (67.0%, 71/106) aimed to educate viewers about the topic. Conclusions: This study explored sedentary behavior content available on YouTube. Findings demonstrate that there is confusion between physical activity and sedentary behaviors, that content is being uploaded to the site from around the globe, that content is primarily from health organizations and individuals with the purpose of educating fellow users, but that low views, comments, and shares suggest that sedentary behavior content is relatively underutilized on YouTube. Future research may wish to leverage social platforms, such as YouTube, to facilitate implementation and sharing of evidence-based sedentary behavior content.

  • Unsupervised clustering of the high-risk patients identified consistent distinct subgroups in the prospective cohort.

    Real-Time Web-Based Assessment of Total Population Risk of Future Emergency Department Utilization: Statewide Prospective Active Case Finding Study

    Abstract:

    Background: An easily accessible real-time Web-based utility to assess patient risks of future emergency department (ED) visits can help the health care provider guide the allocation of resources to better manage higher-risk patient populations and thereby reduce unnecessary use of EDs. Objective: Our main objective was to develop a Health Information Exchange-based, next 6-month ED risk surveillance system in the state of Maine. Methods: Data on electronic medical record (EMR) encounters integrated by HealthInfoNet (HIN), Maine’s Health Information Exchange, were used to develop the Web-based surveillance system for a population ED future 6-month risk prediction. To model, a retrospective cohort of 829,641 patients with comprehensive clinical histories from January 1 to December 31, 2012 was used for training and then tested with a prospective cohort of 875,979 patients from July 1, 2012, to June 30, 2013. Results: The multivariate statistical analysis identified 101 variables predictive of future defined 6-month risk of ED visit: 4 age groups, history of 8 different encounter types, history of 17 primary and 8 secondary diagnoses, 8 specific chronic diseases, 28 laboratory test results, history of 3 radiographic tests, and history of 25 outpatient prescription medications. The c-statistics for the retrospective and prospective cohorts were 0.739 and 0.732 respectively. Integration of our method into the HIN secure statewide data system in real time prospectively validated its performance. Cluster analysis in both the retrospective and prospective analyses revealed discrete subpopulations of high-risk patients, grouped around multiple “anchoring” demographics and chronic conditions. With the Web-based population risk-monitoring enterprise dashboards, the effectiveness of the active case finding algorithm has been validated by clinicians and caregivers in Maine. Conclusions: The active case finding model and associated real-time Web-based app were designed to track the evolving nature of total population risk, in a longitudinal manner, for ED visits across all payers, all diseases, and all age groups. Therefore, providers can implement targeted care management strategies to the patient subgroups with similar patterns of clinical histories, driving the delivery of more efficient and effective health care interventions. To the best of our knowledge, this prospectively validated EMR-based, Web-based tool is the first one to allow real-time total population risk assessment for statewide ED visits.

  • Untitled. 
Image for the Table of Contents thumbnail: Picture of a resting old man.
Copyright details: Free for commercial use / No attribution required.
Source URL: http://pixabay.com/en/resting-old-man-human-bench-50442/.

    Perceived Reasons, Incentives, and Barriers to Physical Activity in Swedish Elderly Men

    Abstract:

    Background: Knowledge about factors influencing physical activity behavior is needed in order to tailor physical activity interventions to the individual. Objective: The aim of this study was to explore and describe the perceived reasons, barriers, and incentives to increased physical activity, as well as preferable activities, among elderly men in Sweden. Methods: In total, 150 men aged 50-86 years responded to a Web-based questionnaire. Men who reported that they exercised sometimes or often received questions about reasons for physical activity (n=104), while men who reported that they never or seldom exercised received questions about barriers (n=46). Results: The most frequent perceived reason for being physically active was health (82%), followed by enjoyment (45%), and a desire to lose/maintain weight (27%). Lack of interest/motivation was identified as the primary perceived barrier (17%). Incentives for increasing the level of activity included becoming more motivated and having a training partner. Walking was the most preferred activity. Conclusions: Enjoyment and maintaining a good health were important reasons for engaging in physical activity among Swedish elderly men.

  • Table 2-2.

    Validity and Usability of Low-Cost Accelerometers for Internet-Based Self-Monitoring of Physical Activity in Patients With Chronic Obstructive Pulmonary Disease

    Abstract:

    Background: The importance of regular physical activity for patients with chronic obstructive pulmonary disease (COPD) is well-established. However, many patients do not meet the recommended daily amount. Accelerometers might provide patients with the information needed to increase physical activity in daily life. Objective: Our objective was to assess the validity and usability of low-cost Internet-connected accelerometers. Furthermore we explored patients’ preferences with regards to the presentation of and feedback on monitored physical activity. Methods: To assess concurrent validity we conducted a field validation study with patients who wore two low-cost accelerometers, Fitbit and Physical Activity Monitor (PAM), at the same time along with a sophisticated multisensor accelerometer (SenseWear Armband) for 48 hours. Data on energy expenditure assessed from registrations from the two low-cost accelerometers were compared to the well validated SenseWear Armband which served as a reference criterion. Usability was examined in a cross-over study with patients who, in succession, wore the Fitbit and the PAM for 7 consecutive days and filled out a 16 item questionnaire with regards to the use of the corresponding device Results: The agreement between energy expenditure (METs) from the SenseWear Armband with METs estimated by the Fitbit and PAM was good (r=.77) and moderate (r=.41), respectively. The regression model that was developed for the Fitbit explained 92% whereas the PAM-model could explain 89% of total variance in METs measured by the SenseWear. With regards to the usability, both the Fitbit and PAM were well rated on all items. There were no significant differences between the two devices. Conclusions: The low-cost Fitbit and PAM are valid and usable devices to measure physical activity in patients with COPD. These devices may be useful in long-term interventions aiming at increasing physical activity levels in these patients.

  • By jannoon028, published on 07 August 2011 Stock Photo - image ID: 10052994; http://www.freedigitalphotos.net/images/Dentistry_g416-Dental_Tools_And_Equipment_p52994.html.

    The Relation Between Caregivers' Multiliterate Reading Habits and Their Children's Oral Health Status

    Abstract:

    Background: Caregivers’ oral health literacy (OHL) assessment results have been found to be related to their children’s oral health status. A further aspect of this relationship may be the role of caregivers’ reading habits. Objective: Our goal was to describe the relationship between caregivers’ multimodal (digital and print) and multilingual (English and Chinese) reading habits, their OHL, and their child’s oral health status in Hong Kong. Methods: A random sample of 301 child-caregiver dyads was recruited from kindergartens in Hong Kong. Data included sociodemographic information and caregivers’ self-reported digital print and reading habits across two languages (Chinese and English). Caregivers’ OHL levels were assessed by two locally developed and validated oral health literacy assessment tasks: Hong Kong Rapid Estimate of Adult Literacy in Dentistry-30 (HKREALD-30) and the Hong Kong Oral Health Literacy Assessment Task for Pediatric Dentistry (HKOHLAT-P). Children’s oral health status was assessed using two measures: dental caries experience (number of decayed, missing, and filled teeth) and oral hygiene status (Visible Plaque Index). Results: Bivariate variations revealed significant differences in mean OHL scores between caregivers with different reading habits (P<.01). Correlations revealed significant associations between caregivers’ practices of reading multimodal (print/digital) and multilingual (English/Chinese) texts, their literacy levels, and their children’s oral health status (P<.01). Adjusting for sociodemographics and all other reading habits in the regression analysis, the caregivers' habit of reading digital and print texts was significantly retained in the final model. Regression analysis revealed significant associations between caregivers’ reading habits (digital Chinese) and their OHL word recognition scores: OR 5.00, 95% CI 1.10-3.65, P=.027. Significant associations were also evident for their OHL comprehension scores (digital Chinese: OR 2.30, 95% CI 1.30-4.20, P=.004; print Chinese: OR 2.50, 95% CI 1.40-4.30, P=.001). However, no significant associations were found between caregivers' reading habits and child’s oral health status (P>.05). Conclusions: Caregivers’ habits of reading print and digital Chinese texts are significantly associated with their OHL scores. Their reading habits, however, do not affect their children’s oral health status.

  • This image is from the public domain (http://en.wikipedia.org/wiki/Multiple_sclerosis#mediaviewer/File:Symptoms_of_multiple_sclerosis.svg).

    Web Search Behavior and Information Needs of People With Multiple Sclerosis: Focus Group Study and Analysis of Online Postings

    Abstract:

    Background: Multiple sclerosis (MS) patients and their family members increasingly seek health information on the Internet. There has been little exploration of how MS patients integrate health information with their needs, preferences, and values for decision making. The INtegrating and Deriving Evidence, Experiences, and Preferences (IN-DEEP) project is a collaboration between Italian and Australian researchers and MS patients, aimed to make high-quality evidence accessible and meaningful to MS patients and families, developing a Web-based resource of evidence-based information starting from their information needs. Objective: The objective of this study was to analyze MS patients and their family members’ experience about the Web-based health information, to evaluate how they asses this information, and how they integrate health information with personal values. Methods: We organized 6 focus groups, 3 with MS patients and 3 with family members, in the Northern, Central, and Southern parts of Italy (April-June 2011). They included 40 MS patients aged between 18 and 60, diagnosed as having MS at least 3 months earlier, and 20 family members aged 18 and over, being relatives of a person with at least a 3-months MS diagnosis. The focus groups were audio-recorded and transcribed verbatim (Atlas software, V 6.0). Data were analyzed from a conceptual point of view through a coding system. An online forum was hosted by the Italian MS society on its Web platform to widen the collection of information. Nine questions were posted covering searching behavior, use of Web-based information, truthfulness of Web information. At the end, posts were downloaded and transcribed. Results: Information needs covered a comprehensive communication of diagnosis, prognosis, and adverse events of treatments, MS causes or risk factors, new drugs, practical, and lifestyle-related information. The Internet is considered useful by MS patients, however, at the beginning or in a later stage of the disease a refusal to actively search for information could occur. Participants used to search on the Web before or after their neurologist’s visit or when a new therapy was proposed. Social networks are widely used to read others’ stories and retrieve information about daily management. A critical issue was the difficulty of recognizing reliable information on the Web. Many sources were used but the neurologist was mostly the final source of treatment decisions. Conclusions: MS patients used the Internet as a tool to integrate information about the illness. Information needs covered a wide spectrum, the searched topics changed with progression of the disease. Criteria for evaluating Internet accuracy and credibility of information were often lacking or generic. This may limit the empowerment of patients in health care choices.

  • (cc) Pitter et al. CC-BY-SA-2.0, please cite as (http://www.i-jmr.org/article/viewFile/3160/1/42141).

    The Impact of Different Surgical Modalities for Hysterectomy on Satisfaction and Patient Reported Outcomes

    Abstract:

    Background: There is an ongoing debate regarding the cost-benefit of different surgical modalities for hysterectomy. Studies have relied primarily on evaluation of clinical outcomes and medical expenses. Thus, a paucity of information on patient-reported outcomes including satisfaction, recovery, and recommendations exists. Objective: The objective of this study was to identify differences in patient satisfaction and recommendations by approach to a hysterectomy. Methods: We recruited a large, geographically diverse group of women who were members of an online hysterectomy support community. US women who had undergone a benign hysterectomy formed this retrospective study cohort. Self-reported characteristics and experiences were compared by surgical modality using chi-square tests. Outcomes over time were assessed with the Jonkheere-Terpstra trend test. Logistic regression identified independent predictors of patient satisfaction and recommendations. Results: There were 6262 women who met the study criteria; 41.74% (2614/6262) underwent an abdominal hysterectomy, 10.64% (666/6262) were vaginal, 27.42% (1717/6262) laparoscopic, 18.94% (1186/6262) robotic, and 1.26% (79/6262) single-incision laparoscopic. Most women were at least college educated (56.37%, 3530/6262), and identified as white, non-Hispanic (83.17%, 5208/6262). Abdominal hysterectomy rates decreased from 68.2% (152/223) to 24.4% (75/307), and minimally invasive surgeries increased from 31.8% (71/223) to 75.6% (232/307) between 2001 or prior years and 2013 (P<.001 all trends). Trends in overall patient satisfaction and recommendations showed significant improvement over time (P<.001).There were differences across the surgical modalities in all patient-reported experiences (ie, satisfaction, time to walking, driving and working, and whether patients would recommend or use the same technique again; P<.001). Significantly better outcomes were evident among women who had vaginal, laparoscopic, and robotic procedures than among those who had an abdominal procedure. However, robotic surgery was the only approach that was an independent predictor of better patient experience; these patients were more satisfied overall (odds ratio [OR] 1.31, 95% CI 1.13-1.51) and on six other satisfaction measures, and more likely to recommend (OR 1.64, 95% CI 1.39-1.94) and choose the same modality again (OR 2.07, 95% CI 1.67-2.57). Abdominal hysterectomy patients were more dissatisfied with outcomes after surgery and less likely to recommend (OR 0.36, 95% CI 0.31-0.40) or choose the same technique again (OR 0.29, 95% CI 0.25-0.33). Quicker return to normal activities and surgery after 2007 also were independently associated with better overall satisfaction, willingness to recommend, and to choose the same surgery again. Conclusions: Consistent with other US data, laparoscopic and robotic hysterectomy rates increased over time, with a concomitant decline in abdominal hysterectomy. While inherent shortcomings of this retrospective Web-based study exist, findings show that patient experience was better for each of the major minimally invasive approaches than for abdominal hysterectomy. However, robotic-assisted hysterectomy was the only modality that independently predicted greater satisfaction and willingness to recommend and have the same procedure again.

  • This image depicts the IDF humanitarian mission

    Military Medicine Publications: What has Happened in the Past Two Decades?

    Abstract:

    Background: Military medical personnel, like all other physician specialists, face the challenge of keeping updated with developments in their field of expertise, in view of the great amount of new medical information published in the literature. The availability of the Internet has triggered tremendous changes in publication characteristics, and in some fields, the number of publications has increased substantially. The emergence of electronic open access journals and the improvement in Web search engines has triggered a significant change in the publication processes and in accessibility of information. Objective: The objective of this study was to characterize the temporal trends in the number and types of publications in military medicine in the medical literature. Methods: We searched all PubMed-registered publications from January 1, 1990 to December 31, 2010 using the keywords “military” or “army”. We used the publication tag in PubMed to identify and examine major publication types. The trends were tested using the Mann-Kendall test for trend. Results: Our search yielded 44,443 publications in military medicine during the evaluation period. Overall, the number of publications showed two distinct phases over time: (1) a moderate increase from 1990 to 2001 with a mean annual increase of 2.78% (r2=.79, P<.002), and (2) a steeper mean annual increase of 11.20% (r2=.96, P<.002) from 2002 to 2010. Most of the examined publication types showed a similar pattern. The proportion of high-quality-of-evidence publication types (randomized controlled trials, systematic reviews, and meta-analyses) increased from 2.91% to 8.43% of the overall military medicine publications with a mean annual incremental increase of 14.20%. These publication types demonstrated a similar dual phase pattern of increase (10.01%, r2=.80, P<.002 for 1990-2001 and 20.66%, r2=.88, P<.002 for 2002-2010). Conclusions: We conclude that over the past twenty years, scholarly work in the field of military medicine has shown a significant increase in volume, particularly among high quality publication types. However, practice guidelines remain rare, and meta-analyses are still limited in number.

  • ©iStockphoto.com/rarecare.

    A European Network of Email and Telephone Help Lines Providing Information and Support on Rare Diseases: Results From a 1-Month Activity Survey

    Abstract:

    Background: Information on rare diseases are often complex to understand, or difficult to access and additional support is often necessary. Rare diseases helplines work together across Europe to respond to calls and emails from the public at large, including patients, health care professionals, families, and students. Measuring the activity of helplines can help decision makers to allocate adequate funds when deciding to create or expand an equivalent service. Objective: Data presented are referred to a monthly user profile analysis, which is one of the activities that each helpline has to carry out to be part of the network. This survey aimed to explore the information requests and characteristics of users of rare diseases helplines in different European countries. Another aim was to analyze these data with respect to users’ characteristics, helpline characteristics, topics of the inquiries, and technologies used to provide information. With this survey, we measure data that are key for planning information services on rare diseases in the context of the development of national plans for rare diseases. Methods: A survey was conducted based on all calls, emails, visits, or letters received from November 1 to 30, 2012 to monitor the activity represented by 12 helplines. Data were collected by a common standardized form, using ORPHA Codes for rare diseases, when applicable. No personal data identifying the inquirer were collected. It was a descriptive approach documenting on the number and purpose of inquiries, the number of respondents, the mode of contact, the category of the inquirer in relation to the patient, the inquirer’s gender, age and region of residence, the patient’s age when applicable, the type and duration of response, and the satisfaction as scored by the respondents. Results: A total of 1676 calls, emails, or letters were received from November 1 to 30, 2012. Inquiries were mostly about specific diseases. An average of 23 minutes was spent for each inquiry. The inquirer was a patient in 571/1676 inquiries (ie, 34.07% of all cases; 95% CI 31.8-36.3). Other inquirers included relatives (520/1676, 31.03%; 95% CI 28.9-33.3), health care professionals (354/1676, 21.12%; 95% CI 19.2-23.1), and miscellaneous inquirers (230/1676, 13.72%; 95% CI 12.1-15.4). Telephone remained the main mode of contact (988/1676, 58.95%; 95% CI 56.6-61.3), followed by emails (609/1676, 36.34%; 95% CI 34.0-38.6). The three main reasons of inquiries were to acquire about information on the disease (682/2242, 30.42%; 95% CI 27.8-32.1), a specialized center/expert (404/2242, 18.02%; 95% CI 15.9-19.6), and social care (240/2242, 10.70%; 95% CI 9.1-12.0). Conclusions: The helplines service responds to the demands of the public, however more inquiry-categories could be responded to. This leaves the possibility to expand the scope of the helplines, for example by providing assistance to patients when they are reporting suspected adverse drug reactions as provided by Directive 2010/84/EU or by providing information on patients’ rights to cross-border care, as provided by Directive 2010/24/EU.

  • (cc) by Chiragpatel90, CC-BY-SA 3.0 (http://commons.wikimedia.org/wiki/File%3ANikeFuelband.jpg).

    A Qualitative Analysis of User Experiences With a Self-Tracker for Activity, Sleep, and Diet

    Authors List:

    Abstract:

    Background: The recent increase in chronic diseases and an aging population warrant the necessity of health self-management. As small electronic devices that track one’s activity, sleep, and diet, called self-trackers, are being widely distributed, it is prudent to investigate the user experience and the effectiveness of these devices, and use the information toward engineering better devices that would result in increased efficiency and usability. Objective: The aim of this study was to abstract the constructs that constitute the user experiences of the self-tracker for activity, sleep, and diet. Additionally, we aimed to develop and verify the Health Information Technology Acceptance Model-II (HITAM-II) through a qualitative data analysis approach. Methods: The study group consisted of 18 female college students who participated in an in-depth interview after completing a 3-month study of utilizing a self-tracker designed to monitor activity, sleep, and diet. The steps followed in the analysis were: (1) extraction of constructs from theoretical frameworks, (2) extraction of constructs from interview data using a qualitative methodology, and (3) abstraction of constructs and modeling of the HITAM-II. Results: The constructs that constitute the HITAM-II are information technology factors, personal factors, social factors, attitude, behavioral intention, and behavior. These constructs are further divided into subconstructs to additionally support the HITAM-II. Conclusions: The HITAM-II was found to successfully describe the health consumer’s attitude, behavioral intention, and behavior from another perspective. The result serves as the basis for a unique understanding of the user experiences of HIT.

  • Physicians use knowledge resources frequently. 
(c) 2014 Mayo Foundation.

    Speed and Accuracy of a Point of Care Web-Based Knowledge Resource for Clinicians: A Controlled Crossover Trial

    Abstract:

    Background: Effective knowledge translation at the point of care requires that clinicians quickly find correct answers to clinical questions, and that they have appropriate confidence in their answers. Web-based knowledge resources can facilitate this process. Objective: The objective of our study was to evaluate a novel Web-based knowledge resource in comparison with other available Web-based resources, using outcomes of accuracy, time, and confidence. Methods: We conducted a controlled, crossover trial involving 59 practicing clinicians. Each participant answered questions related to two clinical scenarios. For one scenario, participants used a locally developed Web-based resource, and for the second scenario, they used other self-selected Web-based resources. The local knowledge resource (“AskMayoExpert”) was designed to provide very concise evidence-based answers to commonly asked clinical questions. Outcomes included time to a correct response with at least 80% confidence (primary outcome), accuracy, time, and confidence. Results: Answers were more often accurate when using the local resource than when using other Web-based resources, with odds ratio 6.2 (95% CI 2.6-14.5; P<.001) when averaged across scenarios. Time to find an answer was faster, and confidence in that answer was consistently higher, for the local resource (P<.001). Overconfidence was also less frequent with the local resource. In a time-to-event analysis, the chance of responding correctly with at least 80% confidence was 2.5 times greater when using the local resource than with other resources (95% CI 1.6-3.8; P<.001). Conclusions: Clinicians using a Web-based knowledge resource designed to provide quick, concise answers at the point of care found answers with greater accuracy and confidence than when using other self-selected Web-based resources. Further study to improve the design and implementation of knowledge resources may improve point of care learning.

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  • Disease Risk Rule Analysis of the New Rural Cooperative Medical System

    Date Submitted: Dec 15, 2014

    Open Peer Review Period: Dec 24, 2014 - Feb 18, 2015

    Background: With data drawn from Beijing’s New Rural Cooperative Medical System (NRCMS), the disease risk association rules of participating rural residents is studied in terms of risk factors and r...

    Background: With data drawn from Beijing’s New Rural Cooperative Medical System (NRCMS), the disease risk association rules of participating rural residents is studied in terms of risk factors and risk measures, and the rule characteristics of Beijing’s NRCMS disease risks are mined therefrom Objective: With data drawn from Beijing’s New Rural Cooperative Medical System (NRCMS), the disease risk association rules of participating rural residents is studied in terms of risk factors and risk measures, and the rule characteristics of Beijing’s NRCMS disease risks are mined therefrom Methods: The association rule algorithm is utilized to recover both potentially valuable knowledge and decision-making information from NRCMS data. Results: The main objects of healthcare in Beijing from 2012 to 2013 include: circulatory diseases in patients 41 years of age or older, pediatric respiratory disease prevention, reproductive health care for women of childbearing age, and the prevention and treatment of diabetes in female patients; in county-level hospitals with a relatively low average level of consumption, injuries still resulted in high expenses; the primary post-NRCMS reimbursement level-3 and level-4 high-risk groups were patients of 41-65 years of age. Conclusions: According to the ranking of rule supports, the highest support rule in Beijing is that of the circulatory diseases of middle-aged patients, especially patients that are hospitalized in county-level medical institutions; the second highest support comes from the utilization of fertility services for women of childbearing age.