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  • 文章类型: Journal Article
    背景:术后感染仍然是医疗保健领域的重要挑战,导致高发病率,死亡率,和成本。术后细菌感染患者的准确识别和标记对于开发预测模型至关重要,验证生物标志物,并在临床实践中实施监测系统。
    目的:本范围审查旨在探索使用电子健康记录(EHR)数据识别术后感染患者的方法,以超越手动图表审查的参考标准。
    方法:我们在PubMed,Embase,WebofScience(核心合集),Cochrane图书馆,和Emcare(Ovid),针对预测和全自动监测的目标研究(即,无需手动检查)术后设置的多种细菌感染。对于预测建模研究,我们评估了使用的标记方法,将它们分类为手动或自动。我们评估了术后感染监测和标记所需的不同类型的EHR数据,以及与手动图表审查相比,全自动监视系统的性能。
    结果:我们在2003年至2023年之间发表的研究中确定了75种不同的方法和定义,用于识别术后感染的患者。手动标注是预测建模研究中的主要方法,65%(49/75)的确定方法使用结构化数据,45%(34/75)使用自由文本和临床笔记作为他们的数据源之一。应谨慎使用全自动监测系统,因为报告的阳性预测值在0.31至0.76之间。
    结论:目前没有证据支持完全自动化的标记和识别感染患者仅基于结构化的EHR数据。未来的研究应该集中在定义统一的定义上,以及优先开发更具可扩展性的产品,使用结构化EHR数据进行感染检测的自动化方法。
    BACKGROUND: Postoperative infections remain a crucial challenge in health care, resulting in high morbidity, mortality, and costs. Accurate identification and labeling of patients with postoperative bacterial infections is crucial for developing prediction models, validating biomarkers, and implementing surveillance systems in clinical practice.
    OBJECTIVE: This scoping review aimed to explore methods for identifying patients with postoperative infections using electronic health record (EHR) data to go beyond the reference standard of manual chart review.
    METHODS: We performed a systematic search strategy across PubMed, Embase, Web of Science (Core Collection), the Cochrane Library, and Emcare (Ovid), targeting studies addressing the prediction and fully automated surveillance (ie, without manual check) of diverse bacterial infections in the postoperative setting. For prediction modeling studies, we assessed the labeling methods used, categorizing them as either manual or automated. We evaluated the different types of EHR data needed for the surveillance and labeling of postoperative infections, as well as the performance of fully automated surveillance systems compared with manual chart review.
    RESULTS: We identified 75 different methods and definitions used to identify patients with postoperative infections in studies published between 2003 and 2023. Manual labeling was the predominant method in prediction modeling research, 65% (49/75) of the identified methods use structured data, and 45% (34/75) use free text and clinical notes as one of their data sources. Fully automated surveillance systems should be used with caution because the reported positive predictive values are between 0.31 and 0.76.
    CONCLUSIONS: There is currently no evidence to support fully automated labeling and identification of patients with infections based solely on structured EHR data. Future research should focus on defining uniform definitions, as well as prioritizing the development of more scalable, automated methods for infection detection using structured EHR data.
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  • 文章类型: Journal Article
    彻底的文献检索是范围审查的关键特征。我们调查了社会科学研究人员在范围审查中报告的搜索实践。我们从社会科学引文索引中收集了2015年至2021年之间发表的范围审查评论。在纳入的2484项研究中,我们观察到发表的评论平均每年增长58%,主要来自临床和应用社会科学学科。书目数据库包括主要搜索策略中的大部分信息源(n=9565,75%),尽管报告实践各不相同。大多数范围审查(n=1805,73%)包括至少一个补充搜索策略。少数研究(n=713,29%)承认LIS专业,很少列出一个作为合著者(n=194,8%)。我们得出的结论是,为了改善报告并加强范围审查方法在社会科学中的影响,研究人员应该考虑(1)遵守PRISMA-S报告指南,(2)采用更多的辅助搜索策略,(3)与LIS专业人员合作。
    A thorough literature search is a key feature of scoping reviews. We investigated the search practices used by social science researchers as reported in their scoping reviews. We collected scoping reviews published between 2015 and 2021 from Social Science Citation Index. In the 2484 included studies, we observed a 58% average annual increase in published reviews, primarily from clinical and applied social science disciplines. Bibliographic databases comprised most of the information sources in the primary search strategy (n = 9565, 75%), although reporting practices varied. Most scoping reviews (n = 1805, 73%) included at least one supplementary search strategy. A minority of studies (n = 713, 29%) acknowledged an LIS professional and few listed one as a co-author (n = 194, 8%). We conclude that to improve reporting and strengthen the impact of the scoping review method in the social sciences, researchers should consider (1) adhering to PRISMA-S reporting guidelines, (2) employing more supplementary search strategies, and (3) collaborating with LIS professionals.
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  • 文章类型: Journal Article
    背景:远程医疗和远程医疗是重要的家庭护理服务,用于支持个人在家中更独立地生活。历史上,这些技术对问题做出了反应。然而,最近一直在努力更好地利用这些服务的数据,以促进更积极和预测性的护理。
    目的:这篇综述旨在探索预测数据分析技术在家庭远程医疗和远程医疗中的应用方式。
    方法:PRISMA-ScR(系统审查的首选报告项目和范围审查的荟萃分析扩展)清单与Arksey和O\'Malley的方法论框架一起遵循。在MEDLINE发表的英文论文,Embase,并考虑了2012年至2022年的社会科学保费收集,并根据纳入或排除标准对结果进行了筛选.
    结果:总计,这篇综述包括86篇论文。本综述中的分析类型可以归类为异常检测(n=21),诊断(n=32),预测(n=22),和活动识别(n=11)。最常见的健康状况是帕金森病(n=12)和心血管疾病(n=11)。主要发现包括:缺乏使用常规收集的数据;诊断工具占主导地位;以及存在的障碍和机会,例如包括患者报告的结果,用于未来的远程医疗和远程医疗预测分析。
    结论:这篇综述中的所有论文都是小规模的飞行员,因此,未来的研究应该寻求将这些预测技术应用到更大的试验中。此外,将常规收集的护理数据和患者报告的结局进一步整合到远程医疗和远程医疗的预测模型中,为改善正在进行的分析提供了重要的机会,应进一步探讨.使用的数据集必须具有合适的大小和多样性,确保模型可推广到更广泛的人群,并且可以进行适当的训练,已验证,和测试。
    BACKGROUND: Telecare and telehealth are important care-at-home services used to support individuals to live more independently at home. Historically, these technologies have reactively responded to issues. However, there has been a recent drive to make better use of the data from these services to facilitate more proactive and predictive care.
    OBJECTIVE: This review seeks to explore the ways in which predictive data analytics techniques have been applied in telecare and telehealth in at-home settings.
    METHODS: The PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) checklist was adhered to alongside Arksey and O\'Malley\'s methodological framework. English language papers published in MEDLINE, Embase, and Social Science Premium Collection between 2012 and 2022 were considered and results were screened against inclusion or exclusion criteria.
    RESULTS: In total, 86 papers were included in this review. The types of analytics featuring in this review can be categorized as anomaly detection (n=21), diagnosis (n=32), prediction (n=22), and activity recognition (n=11). The most common health conditions represented were Parkinson disease (n=12) and cardiovascular conditions (n=11). The main findings include: a lack of use of routinely collected data; a dominance of diagnostic tools; and barriers and opportunities that exist, such as including patient-reported outcomes, for future predictive analytics in telecare and telehealth.
    CONCLUSIONS: All papers in this review were small-scale pilots and, as such, future research should seek to apply these predictive techniques into larger trials. Additionally, further integration of routinely collected care data and patient-reported outcomes into predictive models in telecare and telehealth offer significant opportunities to improve the analytics being performed and should be explored further. Data sets used must be of suitable size and diversity, ensuring that models are generalizable to a wider population and can be appropriately trained, validated, and tested.
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  • 文章类型: Journal Article
    背景:心血管疾病患者不坚持用药会损害预期的治疗结果。eHealth干预措施成为有效解决这一问题的有希望的策略。
    目的:这项研究的目的是进行网络荟萃分析(NMA),以比较和排名各种电子健康干预措施在改善心血管疾病(CVDs)患者服药依从性方面的功效。
    方法:在PubMed中进行了系统的搜索策略,Embase,WebofScience,科克伦,中国国家知识基础设施图书馆(CNKI),中国科技期刊数据库(维普),和万方数据库搜索从2024年1月15日开始发表的随机对照试验(RCT)。我们进行了频繁的NMA来比较各种电子健康干预措施的疗效。使用Cochrane手册(2.0版)中的偏见风险工具评估文献的质量,提取的数据使用Stata16.0(StataCorpLLC)和RevMan5.4软件(CochraneCollaboration)进行分析.使用建议分级评估证据的确定性,评估,发展,和评估(等级)方法。
    结果:共纳入21项RCTs,涉及3904例患者。NMA显示,联合干预(标准化平均差[SMD]0.89,95%CI0.22-1.57),电话支持(SMD0.68,95%CI0.02-1.33),远程监护干预措施(SMD0.70,95%CI0.02-1.39),和手机应用干预(SMD0.65,95%CI0.01-1.30)在统计学上优于常规治疗。然而,SMS与平常照护比拟无统计学差别。值得注意的是,联合干预,累积排名曲线下的曲面为79.3%,似乎是最有效的心血管疾病患者的选择。关于收缩压和舒张压结果,联合干预措施成为最佳干预措施的可能性也最高.
    结论:研究表明,联合干预(SMS短信和电话支持)最有可能成为改善心血管疾病患者服药依从性的最有效的电子健康干预措施。其次是远程监测,电话支持,和应用程序干预。这些网络荟萃分析的结果可以为医疗保健提供者提供关键的循证支持,以提高患者的用药依从性。鉴于电子健康干预措施的设计和实施存在差异,进一步大规模,需要精心设计的多中心试验。
    背景:INPLASY2023120063;https://inplasy.com/inplasy-2023-12-0063/。
    BACKGROUND: Nonadherence to medication among patients with cardiovascular diseases undermines the desired therapeutic outcomes. eHealth interventions emerge as promising strategies to effectively tackle this issue.
    OBJECTIVE: The aim of this study was to conduct a network meta-analysis (NMA) to compare and rank the efficacy of various eHealth interventions in improving medication adherence among patients with cardiovascular diseases (CVDs).
    METHODS: A systematic search strategy was conducted in PubMed, Embase, Web of Science, Cochrane, China National Knowledge Infrastructure Library (CNKI), China Science and Technology Journal Database (Weipu), and WanFang databases to search for randomized controlled trials (RCTs) published from their inception on January 15, 2024. We carried out a frequentist NMA to compare the efficacy of various eHealth interventions. The quality of the literature was assessed using the risk of bias tool from the Cochrane Handbook (version 2.0), and extracted data were analyzed using Stata16.0 (StataCorp LLC) and RevMan5.4 software (Cochrane Collaboration). The certainty of evidence was evaluated using the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) approach.
    RESULTS: A total of 21 RCTs involving 3904 patients were enrolled. The NMA revealed that combined interventions (standardized mean difference [SMD] 0.89, 95% CI 0.22-1.57), telephone support (SMD 0.68, 95% CI 0.02-1.33), telemonitoring interventions (SMD 0.70, 95% CI 0.02-1.39), and mobile phone app interventions (SMD 0.65, 95% CI 0.01-1.30) were statistically superior to usual care. However, SMS compared to usual care showed no statistical difference. Notably, the combined intervention, with a surface under the cumulative ranking curve of 79.3%, appeared to be the most effective option for patients with CVDs. Regarding systolic blood pressure and diastolic blood pressure outcomes, the combined intervention also had the highest probability of being the best intervention.
    CONCLUSIONS: The research indicates that the combined intervention (SMS text messaging and telephone support) has the greatest likelihood of being the most effective eHealth intervention to improve medication adherence in patients with CVDs, followed by telemonitoring, telephone support, and app interventions. The results of these network meta-analyses can provide crucial evidence-based support for health care providers to enhance patients\' medication adherence. Given the differences in the design and implementation of eHealth interventions, further large-scale, well-designed multicenter trials are needed.
    BACKGROUND: INPLASY 2023120063; https://inplasy.com/inplasy-2023-12-0063/.
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  • 文章类型: Journal Article
    背景:需要有效的医疗保健服务来满足患有癌症的儿童和青少年的多样化需求,以减轻他们的身体,心理,和社会挑战,提高他们的生活质量。以前的研究表明,严肃的游戏有助于促进人们的健康。然而,严肃的游戏被用于成功控制儿童和青少年癌症的潜力受到的关注较少。
    目的:这项范围审查旨在绘制儿童和青少年癌症预防和癌症护理中严肃游戏的用途,并为儿童和青少年癌症控制背景下严肃游戏的开发和实施提供未来方向。
    方法:本研究遵循PRISMA-ScR(用于系统审查和Meta分析扩展的首选报告项目)和JBI(JoannaBriggsInstitute)框架进行范围审查。PubMed,CINAHL加全文,Scopus,WebofScience核心合集,和美国心理学会(APA)PsycINFO数据库用于搜索。
    结果:从最初的2750个搜索结果来看,63篇论文被纳入审查,有28个定量的,14定性,和21项混合方法研究。大多数研究是癌症护理严重游戏论文(55/63,87%),少数研究是癌症预防严重游戏论文(8/63,13%)。大多数纳入的研究在2019年至2023年之间发表(癌症预防:5/8,63%;癌症护理:35/55,64%)。大多数研究在欧洲进行(癌症预防:3/8,38%;癌症护理:24/55,44%)和北美(癌症预防:4/8,50%;癌症护理:17/55,31%)。青少年是研究参与者中最具代表性的年龄组(癌症预防:8/8,100%;癌症护理:46/55,84%)。所有(8/8,100%)癌症预防严肃的游戏论文都包括健康人作为参与者,55份(82%)癌症护理严肃游戏论文中有45份包括癌症患者。大多数癌症预防严肃的游戏论文将游戏偏好作为目标结果(4/8,50%)。大多数癌症护理严肃的游戏论文将症状管理作为目标结果(28/55,51%)。在癌症护理研究中,检查症状管理的严肃游戏,大多数研究用于治疗心理症状(13/55,24%)和身体症状(10/55,18%).
    结论:这篇综述显示了儿童和青少年对使用严肃游戏控制癌症的兴趣增长,以及相关文献中潜在的偏见。所收录论文的不同特征表明,严肃的游戏可以以各种方式用于儿童和青少年的癌症控制,同时强调需要在代表性不足的地区开发和实施严肃的游戏。
    BACKGROUND: Effective health care services that meet the diverse needs of children and adolescents with cancer are required to alleviate their physical, psychological, and social challenges and improve their quality of life. Previous studies showed that serious games help promote people\'s health. However, the potential for serious games to be used for successful cancer control for children and adolescents has received less attention.
    OBJECTIVE: This scoping review aimed to map the use of serious games in cancer prevention and cancer care for children and adolescents, and provide future directions for serious games\' development and implementation within the context of cancer control for children and adolescents.
    METHODS: This study followed a combination of the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) and the JBI (Joanna Briggs Institute) framework for the conduct of scoping reviews. PubMed, CINAHL Plus Full Text, Scopus, Web of Science Core Collection, and American Psychological Association (APA) PsycINFO databases were used for the search.
    RESULTS: From the initial 2750 search results, 63 papers were included in the review, with 28 quantitative, 14 qualitative, and 21 mixed method studies. Most of the studies were cancer care serious game papers (55/63, 87%) and a small number of studies were cancer prevention serious game papers (8/63, 13%). The majority of the included studies were published between 2019 and 2023 (cancer prevention: 5/8, 63%; cancer care: 35/55, 64%). The majority of the studies were conducted in Europe (cancer prevention: 3/8, 38%; cancer care: 24/55, 44%) and North America (cancer prevention: 4/8, 50%; cancer care: 17/55, 31%). Adolescents were the most represented age group in the studies\' participants (cancer prevention: 8/8, 100%; cancer care: 46/55, 84%). All (8/8, 100%) cancer prevention serious game papers included healthy people as participants, and 45 out of 55 (82%) cancer care serious game papers included patients with cancer. The majority of cancer prevention serious game papers addressed game preference as a target outcome (4/8, 50%). The majority of cancer care serious game papers addressed symptom management as a target outcome (28/55, 51%). Of the cancer care studies examining serious games for symptom management, the majority of the studies were conducted to treat psychological (13/55, 24%) and physical symptoms (10/55, 18%).
    CONCLUSIONS: This review shows both the growth of interest in the use of serious games for cancer control among children and adolescents and the potential for bias in the relevant literature. The diverse characteristics of the included papers suggest that serious games can be used in various ways for cancer control among children and adolescents while highlighting the need to develop and implement serious games in underrepresented areas.
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  • 文章类型: Journal Article
    语义互操作性促进了对电子健康记录(EHR)中记录的具有各种语义特征的健康数据的交换和访问。语义互操作性开发的主要目标需要患者数据的可用性,并在不丧失意义的情况下在不同的EHR中使用。国际上,当前的举措旨在加强EHR数据的语义开发,因此,患者数据的可用性。卫生信息系统之间的互操作性是欧洲卫生数据空间法规提案和世界卫生组织《2020-2025年全球数字卫生战略》的核心目标之一。
    为了实现集成的健康数据生态系统,利益相关者需要克服实现语义互操作性元素的挑战。为了研究语义互操作性发展的现有科学证据,我们定义了以下研究问题:构建集成在EHR中的语义互操作性的关键要素和方法是什么?推动发展的目标是什么?以及在这种发展之后可以感知到什么样的临床益处?
    我们的研究问题集中在语义互操作性的关键方面和方法以及在EHR背景下这些选择可能的临床和语义益处。因此,我们在PubMed中进行了系统的文献综述,根据以往的研究定义了我们的研究框架.
    我们的分析包括14项研究,其中数据模型,本体论,术语,分类,和标准被应用于建筑互操作性。所有文章都报道了所选方法增强语义互操作性的临床益处。我们确定了3个主要类别:增加临床医生的数据可用性(n=6,43%),提高护理质量(n=4,29%),并加强临床数据的使用和重复使用,用于不同的目的(n=4,29%)。关于语义发展目标,不同EHR之间的数据协调和语义互操作性发展是最大的类别(n=8,57%).通过标准化提高健康数据质量(n=5,36%)和开发基于可互操作数据的EHR集成工具(n=1,7%)是其他确定的类别。结果与需要从可通过各种EHR和数据库访问的异构医疗信息中构建可用和可计算的数据(例如,寄存器)。
    当走向临床数据的语义协调时,需要更多的经验和分析来评估所选择的解决方案如何适用于医疗数据的语义互操作性。而不是推广单一的方法,语义互操作性应该通过几个层次的语义需求来评估。双模型或多模型方法可能可用于解决开发过程中的不同语义互操作性问题。语义互操作性的目标将在分散和断开的临床护理环境中实现。因此,增强临床数据可用性的方法应该做好准备,思考出来,并有理由满足经济上可持续和长期的结果。
    UNASSIGNED: Semantic interoperability facilitates the exchange of and access to health data that are being documented in electronic health records (EHRs) with various semantic features. The main goals of semantic interoperability development entail patient data availability and use in diverse EHRs without a loss of meaning. Internationally, current initiatives aim to enhance semantic development of EHR data and, consequently, the availability of patient data. Interoperability between health information systems is among the core goals of the European Health Data Space regulation proposal and the World Health Organization\'s Global Strategy on Digital Health 2020-2025.
    UNASSIGNED: To achieve integrated health data ecosystems, stakeholders need to overcome challenges of implementing semantic interoperability elements. To research the available scientific evidence on semantic interoperability development, we defined the following research questions: What are the key elements of and approaches for building semantic interoperability integrated in EHRs? What kinds of goals are driving the development? and What kinds of clinical benefits are perceived following this development?
    UNASSIGNED: Our research questions focused on key aspects and approaches for semantic interoperability and on possible clinical and semantic benefits of these choices in the context of EHRs. Therefore, we performed a systematic literature review in PubMed by defining our study framework based on previous research.
    UNASSIGNED: Our analysis consisted of 14 studies where data models, ontologies, terminologies, classifications, and standards were applied for building interoperability. All articles reported clinical benefits of the selected approach to enhancing semantic interoperability. We identified 3 main categories: increasing the availability of data for clinicians (n=6, 43%), increasing the quality of care (n=4, 29%), and enhancing clinical data use and reuse for varied purposes (n=4, 29%). Regarding semantic development goals, data harmonization and developing semantic interoperability between different EHRs was the largest category (n=8, 57%). Enhancing health data quality through standardization (n=5, 36%) and developing EHR-integrated tools based on interoperable data (n=1, 7%) were the other identified categories. The results were closely coupled with the need to build usable and computable data out of heterogeneous medical information that is accessible through various EHRs and databases (eg, registers).
    UNASSIGNED: When heading toward semantic harmonization of clinical data, more experiences and analyses are needed to assess how applicable the chosen solutions are for semantic interoperability of health care data. Instead of promoting a single approach, semantic interoperability should be assessed through several levels of semantic requirements A dual model or multimodel approach is possibly usable to address different semantic interoperability issues during development. The objectives of semantic interoperability are to be achieved in diffuse and disconnected clinical care environments. Therefore, approaches for enhancing clinical data availability should be well prepared, thought out, and justified to meet economically sustainable and long-term outcomes.
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  • 文章类型: Journal Article
    背景:在沙特阿拉伯,疫苗犹豫是一个日益严重的问题,甚至影响受过良好教育的父母。决策过程涉及各种因素,例如可访问性,可靠的信息,以及社交网络的影响,反映了复杂的情感相互作用,文化,社会,精神,和政治层面。
    目的:这篇综述旨在评估疫苗犹豫的患病率和趋势,找出促成因素,并探索提高免疫接种率的潜在解决方案。这篇评论符合全球关注的问题,正如世界卫生组织已将疫苗犹豫确定为全球最大的健康威胁。
    方法:我们的系统评价将遵循PRISMA(系统评价和荟萃分析的首选报告项目)指南和PICOS(人口,干预,比较,结果,和研究)综合评估的标准。我们将在各种数据库中进行彻底搜索,包括各种各样的疫苗,并特别注意疫苗接种运动和拒绝。纳入标准涉及描述性,观察,和分析研究,重点是影响疫苗接受或犹豫的因素。该研究将使用Crowe关键评估工具进行质量评估,并进行叙述性综合,以按主题总结发现。
    结果:这项系统评价预计将揭示沙特阿拉伯不同人群疫苗犹豫的患病率和趋势,揭示文化,宗教,以及导致犹豫的社会因素。它旨在评估实施战略的有效性,启用区域和全球比较,并为量身定制的疫苗接种政策提供影响。此外,这篇综述可能会指出研究差距,指导未来的调查,以有效解决和减轻疫苗犹豫。
    结论:研究结果预计将具有直接的政策影响,并指导干预措施,以加强疫苗接种计划和改善公共卫生结果。
    PRR1-10.2196/54680。
    BACKGROUND: Vaccine hesitancy is a growing concern in Saudi Arabia, impacting even well-educated parents. The decision-making process involves various factors such as accessibility, trustworthy information, and the influence of social networks, reflecting a complex interplay of emotional, cultural, social, spiritual, and political dimensions.
    OBJECTIVE: This review seeks to evaluate the prevalence and trends of vaccine hesitancy, identify contributing factors, and explore potential solutions to enhance immunization rates. This review aligns with global concerns, as the World Health Organization has identified vaccine hesitancy as a top global health threat.
    METHODS: Our systematic review will follow the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines and PICOS (Population, Intervention, Comparison, Outcomes, and Study) criteria for comprehensive assessment. We will conduct a thorough search across various databases, encompassing a wide range of vaccines, and pay special attention to vaccination campaigns and refusals. Inclusion criteria involve descriptive, observational, and analytical studies focusing on factors influencing vaccine acceptance or hesitancy. The study will use the Crowe Critical Appraisal Tool for quality assessment and perform a narrative synthesis to summarize findings thematically.
    RESULTS: This systematic review is expected to unveil the prevalence and trends of vaccine hesitancy in diverse populations in Saudi Arabia, shedding light on cultural, religious, and social factors contributing to hesitancy. It aims to assess the effectiveness of implemented strategies, enable regional and global comparisons, and provide implications for tailored vaccination policies. Additionally, the review may pinpoint research gaps, guiding future investigations to address and mitigate vaccine hesitancy effectively.
    CONCLUSIONS: The findings are expected to have direct policy implications and guide interventions to strengthen vaccination programs and improve public health outcomes.
    UNASSIGNED: PRR1-10.2196/54680.
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  • 文章类型: Journal Article
    背景:研究表明,数字年龄歧视,也就是说,与年龄相关的偏见,存在于机器学习(ML)模型的开发和部署中。尽管人们认识到这个问题的重要性,缺乏专门研究ML模型中用于缓解年龄相关偏差的策略以及这些策略的有效性的研究.
    目标:为了弥补这一差距,我们对减少ML中年龄相关偏倚的缓解策略进行了范围审查.
    方法:我们遵循了Arksey和O\'Malley开发的范围审查方法框架。搜索是与信息专家共同开发的,并在6个电子数据库(IEEEXplore,Scopus,WebofScience,CINAHL,EMBASE,和ACM数字图书馆),以及2个额外的灰色文献数据库(OpenGrey和灰色文献报告)。
    结果:我们确定了8篇试图减轻ML方法中年龄相关偏差的出版物。引入与年龄相关的偏见主要是由于数据中缺乏老年人的代表性。减轻偏见的努力被分为三种方法之一:(1)创建一个更平衡的数据集,(2)增加和补充他们的数据,(3)直接修改算法以获得更均衡的结果。
    结论:识别和减轻ML模型中的相关偏差对于促进公平性至关重要,股本,inclusion,和社会效益。我们的分析强调了对严格研究和开发有效缓解方法以解决数字年龄歧视的持续需求。确保ML系统以维护所有个人利益的方式使用。
    背景:开放科学框架AMG5P;https://osf.io/amg5p。
    BACKGROUND: Research suggests that digital ageism, that is, age-related bias, is present in the development and deployment of machine learning (ML) models. Despite the recognition of the importance of this problem, there is a lack of research that specifically examines the strategies used to mitigate age-related bias in ML models and the effectiveness of these strategies.
    OBJECTIVE: To address this gap, we conducted a scoping review of mitigation strategies to reduce age-related bias in ML.
    METHODS: We followed a scoping review methodology framework developed by Arksey and O\'Malley. The search was developed in conjunction with an information specialist and conducted in 6 electronic databases (IEEE Xplore, Scopus, Web of Science, CINAHL, EMBASE, and the ACM digital library), as well as 2 additional gray literature databases (OpenGrey and Grey Literature Report).
    RESULTS: We identified 8 publications that attempted to mitigate age-related bias in ML approaches. Age-related bias was introduced primarily due to a lack of representation of older adults in the data. Efforts to mitigate bias were categorized into one of three approaches: (1) creating a more balanced data set, (2) augmenting and supplementing their data, and (3) modifying the algorithm directly to achieve a more balanced result.
    CONCLUSIONS: Identifying and mitigating related biases in ML models is critical to fostering fairness, equity, inclusion, and social benefits. Our analysis underscores the ongoing need for rigorous research and the development of effective mitigation approaches to address digital ageism, ensuring that ML systems are used in a way that upholds the interests of all individuals.
    BACKGROUND: Open Science Framework AMG5P; https://osf.io/amg5p.
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  • 文章类型: Journal Article
    背景:在护理教育中,弥合理论知识和实践技能之间的差距对于培养临床实践能力至关重要。护理学生在获得这些基本技能时遇到挑战,使自我效能感成为他们专业发展的重要组成部分。自我效能感与个人对执行任务和克服挑战的能力的信念有关,对临床技能获取和学术成功具有重要意义。先前的研究强调了护理专业学生的自我效能感与其临床能力之间的紧密联系。技术已经成为一种有前途的工具,通过实现个性化的学习体验和深入的讨论来增强自我效能感。然而,有必要进行全面的文献审查,以评估现有的知识体系并确定研究差距。
    目的:本研究的目的是系统地绘制和识别已发表的关于使用技术支持指导模式来激发护生在临床实践中的自我效能感的研究中的差距。
    方法:本范围审查遵循Arksey和O\'Malley的框架,并根据系统审查和范围审查荟萃分析的首选报告项目(PRISMA-ScR)进行报告。一个系统的,在ERIC进行了全面的文献检索,CINAHL,MEDLINE,Embase,PsycINFO,和WebofScience在2011年1月至2023年4月之间发表的研究。手动搜索所包含论文的参考列表以确定其他研究。成对的作者筛选了这些论文,评估合格,并提取数据。数据是按主题组织的。
    结果:共纳入8项研究,确定了四个主题组:(1)学习支持的技术解决方案,(2)临床实践中的学习重点,(3)自我效能感的教学策略和理论方法,(4)自我效能感和互补结果的评估。
    结论:指导模式采用多种技术方案,激发护生在临床实践中的自我效能感,导致积极的发现。8项研究中有7项结果没有统计学意义,强调需要进一步完善所应用的干预措施。护士教育者在应用学习策略和理论方法来提高护生的自我效能中起着举足轻重的作用。但是护士导师和同龄人的贡献不容忽视。未来的研究应考虑让用户参与干预过程,并使用适合研究干预目标的有效工具。确保相关性并实现跨研究的比较。
    In nursing education, bridging the gap between theoretical knowledge and practical skills is crucial for developing competence in clinical practice. Nursing students encounter challenges in acquiring these essential skills, making self-efficacy a critical component in their professional development. Self-efficacy pertains to individual\'s belief in their ability to perform tasks and overcome challenges, with significant implications for clinical skills acquisition and academic success. Previous research has underscored the strong link between nursing students\' self-efficacy and their clinical competence. Technology has emerged as a promising tool to enhance self-efficacy by enabling personalized learning experiences and in-depth discussions. However, there is a need for a comprehensive literature review to assess the existing body of knowledge and identify research gaps.
    The aim of this study is to systematically map and identify gaps in published studies on the use of technology-supported guidance models to stimulate nursing students\' self-efficacy in clinical practice.
    This scoping review followed the framework of Arksey and O\'Malley and was reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Scoping Reviews (PRISMA-ScR). A systematic, comprehensive literature search was conducted in ERIC, CINAHL, MEDLINE, Embase, PsycINFO, and Web of Science for studies published between January 2011 and April 2023. The reference lists of the included papers were manually searched to identify additional studies. Pairs of authors screened the papers, assessed eligibility, and extracted the data. The data were thematically organized.
    A total of 8 studies were included and four thematic groups were identified: (1) technological solutions for learning support, (2) learning focus in clinical practice, (3) teaching strategies and theoretical approaches for self-efficacy, and (4) assessment of self-efficacy and complementary outcomes.
    Various technological solutions were adopted in the guidance models to stimulate the self-efficacy of nursing students in clinical practice, leading to positive findings. A total of 7 out of 8 studies presented results that were not statistically significant, highlighting the need for further refinement of the applied interventions. Nurse educators play a pivotal role in applying learning strategies and theoretical approaches to enhance nursing students\' self-efficacy, but the contributions of nurse preceptors and peers should not be overlooked. Future studies should consider involving users in the intervention process and using validated instruments tailored to the studies\' intervention objectives, ensuring relevance and enabling comparisons across studies.
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  • 文章类型: Systematic Review
    背景:通过移动应用程序提供的移动健康干预措施越来越多地用于理疗护理。这可能是因为应用程序具有促进行为改变的潜力,这对于物理治疗师提供的护理目标至关重要。使用应用程序的好处是它们能够整合行为改变技术(BCT),可以优化理疗干预的有效性。研究继续表明,尽管它们很重要,在患者管理中经常缺少行为改变策略。评估物理治疗师可以用来驱动行为改变的移动应用程序可以为临床实践提供信息,并有可能改善患者的预后。检查应用程序的质量并探索其可以支持行为改变和理疗护理的关键功能是这种评估的重要方面。
    目的:本研究的主要目的是描述应用商店中用于患者支持理疗的移动应用程序的范围。次要目标是评估应用程序质量,BCT,和他们的行为改变潜力。
    方法:对应用商店中的移动应用进行了系统评价。苹果应用商店和谷歌播放使用两步搜索策略进行搜索,使用与物理治疗学科相关的术语。应用了严格的纳入和排除标准:应用程序必须旨在供患者使用,并且是独立的(或独立的),而无需与合作伙伴可穿戴设备或其他插件结合使用。使用行为更改技术分类第1版对包含的应用程序进行了BCT编码。应用质量使用移动应用评级量表进行评估,和应用程序行为更改量表用于评估应用程序更改行为的潜力。
    结果:总计,筛选了1240个应用程序,包括35个。在这35个应用程序中,22(63%)在AppleAppStore和GooglePlay平台上都可用。总的来说,24人(69%)的焦点一般(例如,不是特定于条件的),其余11人(31%)更具体(例如,膝关节康复和盆底训练)。平均应用程序质量评分(移动应用程序评定量表)为5分之3.7(SD0.4)(范围2.8-4.5)。每个应用程序确定的BCT的平均数量为8.5(SD3.6)。BCT最常包含在应用程序中的是关于如何执行行为的指令(n=32),行动计划(n=30),和行为自我监控(n=28)。平均行为改变潜力评分(应用行为改变量表)为21分之8.5(SD3.1)(范围3-15)。
    结论:可用于支持物理治疗师提供的患者护理的移动应用程序质量参差不齐。虽然它们包含一些BCT,行为改变的可能性在不同的应用程序中差异很大。
    RR2-10.2196/29047。
    BACKGROUND: Mobile health interventions delivered through mobile apps are increasingly used in physiotherapy care. This may be because of the potential of apps to facilitate changes in behavior, which is central to the aims of care delivered by physiotherapists. A benefit of using apps is their ability to incorporate behavior change techniques (BCTs) that can optimize the effectiveness of physiotherapeutic interventions. Research continues to suggest that despite their importance, behavior change strategies are often missing in patient management. Evaluating mobile apps that physiotherapists can use to drive behavior change may inform clinical practice and potentially improve patient outcomes. Examining the quality of apps and exploring their key features that can support behavior change and physiotherapy care are important aspects of such an evaluation.
    OBJECTIVE: The primary aim of this study was to describe the range of mobile apps in app stores that are intended for use by patients to support physiotherapy care. The secondary aims were to assess app quality, BCTs, and their behavior change potential.
    METHODS: A systematic review of mobile apps in app stores was undertaken. The Apple App Store and Google Play were searched using a 2-step search strategy, using terms relevant to the physiotherapy discipline. Strict inclusion and exclusion criteria were applied: apps had to be intended for use by patients and be self-contained (or stand-alone) without the requirement to be used in conjunction with a partner wearable device or another plugin. Included apps were coded for BCTs using the Behavior Change Technique Taxonomy version 1. App quality was assessed using the Mobile App Rating Scale, and the App Behavior Change Scale was used to assess the app\'s potential to change behavior.
    RESULTS: In total, 1240 apps were screened, and 35 were included. Of these 35 apps, 22 (63%) were available on both the Apple App Store and Google Play platforms. In total, 24 (69%) were general in their focus (eg, not condition-specific), with the remaining 11 (31%) being more specific (eg, knee rehabilitation and pelvic floor training). The mean app quality score (Mobile App Rating Scale) was 3.7 (SD 0.4) of 5 (range 2.8-4.5). The mean number of BCTs identified per app was 8.5 (SD 3.6). BCTs most frequently included in the apps were instruction on how to perform a behavior (n=32), action planning (n=30), and self-monitoring of behavior (n=28). The mean behavior change potential score (App Behavior Change Scale) was 8.5 (SD 3.1) of 21 (range 3-15).
    CONCLUSIONS: Mobile apps available to support patient care received from a physiotherapist are of variable quality. Although they contain some BCTs, the potential for behavior change varied widely across apps.
    UNASSIGNED: RR2-10.2196/29047.
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