Medical Informatics

医学信息学
  • 文章类型: Journal Article
    既定的生命历程方法表明,成年期的健康状况可能受到产前发育期发生的事件的影响。然而,孕期饮食和生活方式改变等干预措施对孕产妇和后代健康结局的影响较小.目前,越来越多的文献强调了怀孕前(怀孕前几个月或几年)产妇健康对后代未来健康的重要性。虽然一些研究已经探讨了母亲身体组成等因素,营养,以及这个地区的生活方式,受孕前基于位置的环境和社会经济暴露也可能有助于未来的后代健康。在这行,研究一个病人的地理历史提出了一个有希望的途径。为了促进这个方向的研究,地理空间健康的整合,医学信息学和人工智能技术提供了巨大的潜力。重要的是,大型健康数据集的新来源,例如在初级保健级别注册的电子健康记录,由于其固有的纵向性质,提供了一个独特的框架。尽管如此,一些隐私,伦理,这种纵向分析要成熟和成功,需要克服技术挑战。从长远来看,我们支持将患者的地理历史纳入其临床历史的愿景,为临床医生提供有用的背景信息进行探索.
    Established life course approaches suggest that health status in adulthood can be influenced by events that occurred during the prenatal developmental period. Yet, interventions such as diet and lifestyle changes performed during pregnancy have had a small impact on both maternal and offspring health outcomes. Currently, there is a growing body of literature that highlights the importance of maternal health before conception (months or years before pregnancy occurs) for the future health of offspring. While some studies have explored factors such as maternal body composition, nutrition, and lifestyle in this area, location-based environmental and socioeconomic exposures before conception may also contribute to future offspring health. In this line, the study of a patient\'s geographic history presents a promising avenue. To foster research in this direction, the integration of geospatial health, medical informatics and artificial intelligence techniques offers great potential. Importantly, novel sources of big health data sets such as electronic health records registered at the primary care level provide a unique framework due to its inherent longitudinal nature. Nonetheless, a number of privacy, ethical, and technical challenges need to be overcome for this kind of longitudinal analysis to mature and succeed. In the long-term, we support the vision of incorporating a patient\'s geographic history into her clinical history to equip clinicians with useful contextual information to explore.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

    求助全文

  • 文章类型: Journal Article
    心血管疾病(CV)仍然是发病率和死亡率的主要原因,癌症幸存者的发病率高于普通人群。
    这项研究旨在了解肿瘤学提供者对数字CV健康工具的态度,通过平板电脑递送,促进癌症幸存者的CV健康。
    使用定性方法,14位肿瘤学家,来自社区和学术实践场所,在他们使用该工具时接受了采访。对访谈进行录像,然后使用NVivo11软件进行分析。主题是从访谈中归纳出来的。
    采访中出现了以下三个主要主题:(1)系统功能,(2)融合的促进者和障碍,和(3)适当的最终用户。肿瘤学家认识到CV健康促进在癌症幸存者中的关键作用,并确定了有助于CV健康促进的工具的特征。工作流(子主题)是工具使用的障碍。此反馈使工具能够重新设计,以便在生存护理的背景下进行进一步测试。
    我们的研究结果强调了确定适当的最终用户的重要性,其中可能包括其他生存护理提供者,病人,和初级保健提供者。
    我们的研究解决了在癌症生存护理中使用数字工具的知识差距,特别是促进CV健康的数字工具。需要未来的研究来评估癌症生存护理中的数字工具。调查患者作为数字工具用户的研究可能会提供额外的见解。
    UNASSIGNED: Cardiovascular (CV) disease continues to be a leading cause of morbidity and mortality with higher rates among cancer survivors than in the general population.
    UNASSIGNED: This study was aimed to understand oncology providers\' attitudes toward a digital CV health tool, delivered via a tablet, to promote CV health in cancer survivors.
    UNASSIGNED: Using qualitative methods, 14 oncologists, from community and academic practice sites, were interviewed while they used the tool. Interviews were videotaped then analyzed using NVivo 11 software. Themes were inductively developed from the interviews.
    UNASSIGNED: Three major themes emerged from the interviews as follows: (1) system functionality, (2) facilitators and barriers to integration, and (3) appropriate end-users. Oncologists recognized the critical role of CV health promotion among cancer survivors and identified features about the tool that would be helpful for CV health promotion. Workflow (subtheme) was a barrier to tool use. This feedback enabled tool redesign for further testing in the context of survivorship care.
    UNASSIGNED: Our findings emphasized the importance of identifying appropriate End-users which may include other survivorship care providers, patients, and primary care providers.
    UNASSIGNED: Our research addresses the knowledge gap in the use of digital tools in cancer survivorship care, specifically digital tools to promote CV health. Future research is needed to evaluate digital tools in cancer survivorship care. Research investigating patients as users of digital tools may provide additional insight.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Journal Article
    背景:作为一个新出现的概念和二十一世纪的产物,卫生信息治理正在迅速扩展。医疗行业信息治理的必要性是显而易见的,鉴于健康信息的重要性和当前管理它的需求。本范围审查的目的是确定健康信息治理的维度和组成部分,以发现这些因素如何影响医疗保健系统和服务的增强。
    方法:PubMed,Scopus,WebofScience,ProQuest和GoogleScholar搜索引擎从开始到2024年6月进行了搜索。方法学研究质量使用CASP清单对选定的文件进行评估。尾注20用于选择和审查文章和管理参考资料,MAXQDA2020用于内容分析。
    结果:共37份文件,包括18次审查,9项定性研究和10项混合方法研究,通过文献检索确定。根据调查结果,六个核心类别(包括卫生信息治理目标,优势和应用,原则,组件或元素,角色、责任和流程)和48个子类别被确定,以形成一个统一的总体框架,包括所有提取的维度和组件。
    结论:根据本范围审查的结果,卫生信息治理应被视为各国卫生系统改善和实现目标的必要条件,特别是在发展中国家和不发达国家。此外,鉴于2019年冠状病毒病(COVID-19)大流行在不同国家的不良影响,组织健康信息治理模型的开发和实施,国家和国际层面是紧迫的关切。研究人员可以将当前的发现用作开发健康信息治理模型的综合模型。这项研究的一个可能的限制是我们对某些数据库的访问有限。
    BACKGROUND: As a newly emerged concept and a product of the twenty-first century, health information governance is expanding at a rapid rate. The necessity of information governance in the healthcare industry is evident, given the significance of health information and the current need to manage it. The objective of the present scoping review is to identify the dimensions and components of health information governance to discover how these factors impact the enhancement of healthcare systems and services.
    METHODS: PubMed, Scopus, Web of Science, ProQuest and the Google Scholar search engine were searched from inception to June 2024. Methodological study quality was assessed using CASP checklists for selected documents. Endnote 20 was utilized to select and review articles and manage references, and MAXQDA 2020 was used for content analysis.
    RESULTS: A total of 37 documents, including 18 review, 9 qualitative and 10 mixed-method studies, were identified by literature search. Based on the findings, six core categories (including health information governance goals, advantages and applications, principles, components or elements, roles and responsibilities and processes) and 48 subcategories were identified to form a unified general framework comprising all extracted dimensions and components.
    CONCLUSIONS: Based on the findings of this scoping review, health information governance should be regarded as a necessity in the health systems of various countries to improve and achieve their goals, particularly in developing and underdeveloped countries. Moreover, in light of the undesirable effects of the coronavirus disease 2019 (COVID-19) pandemic in various countries, the development and implementation of health information governance models at organizational, national and international levels are among the pressing concerns. Researchers can use the present findings as a comprehensive model for developing health information governance models. A possible limitation of this study is our limited access to some databases.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Journal Article
    背景:异物(FB)吸入,摄取,插入占耳朵急诊入院的11%,鼻子,和喉咙条件。儿童受到不成比例的影响,和紧急干预可能需要维持气道通畅和防止血管闭塞。高品质,可读的在线信息可以帮助减少FB的不良结果。
    目的:我们旨在评估与FBs相关的在线健康信息的质量和可读性。
    方法:总共,使用Google搜索引擎查询了6个搜索短语。对于每个搜索词,捕获了前30个结果。包括英文网站和显示健康信息。记录了提供者和原产国。改进的36项确保患者质量信息工具用于评估信息质量。使用组合工具评估可读性:Flesch阅读轻松评分,Flesch-Kincaid等级,Gunning-Fog指数,和Gobbledygook的简单测量。
    结果:删除重复项之后,评估了73个网站,大多数来自美国(n=46,63%)。总的来说,内容质量中等,确保患者质量信息的中位数评分为21分(IQR18-25,最大29分),最高可能得分为36分。41%(n=30)的网站没有提到预防措施,30%(n=22)的网站没有将磁盘电池识别为危险的FB。95%(n=69)的网站发现了需要紧急护理的危险信号,89%(n=65)建议患者就医,38%(n=28)建议安全去除FB。可读性得分(Flesch阅读轻松得分=12.4,Flesch-Kincaid等级等级=6.2,Gunning-Fog指数=6.5,Gobbledygook的简单度量=5.9年)显示大多数网站(56%)低于建议的六年级水平。
    结论:关于FBs的信息的当前质量和可读性不足。超过半数的网站高于推荐的六年级阅读水平,和重要的信息,如磁盘电池和磁铁等高风险的fb经常被排除在外。应制定策略,以改善对高质量信息的获取,以告知患者和父母有关风险以及何时寻求医疗帮助。在搜索结果中推广高质量网站的策略也有可能改善结果。
    BACKGROUND: Foreign body (FB) inhalation, ingestion, and insertion account for 11% of emergency admissions for ear, nose, and throat conditions. Children are disproportionately affected, and urgent intervention may be needed to maintain airway patency and prevent blood vessel occlusion. High-quality, readable online information could help reduce poor outcomes from FBs.
    OBJECTIVE: We aim to evaluate the quality and readability of available online health information relating to FBs.
    METHODS: In total, 6 search phrases were queried using the Google search engine. For each search term, the first 30 results were captured. Websites in the English language and displaying health information were included. The provider and country of origin were recorded. The modified 36-item Ensuring Quality Information for Patients tool was used to assess information quality. Readability was assessed using a combination of tools: Flesch Reading Ease score, Flesch-Kincaid Grade Level, Gunning-Fog Index, and Simple Measure of Gobbledygook.
    RESULTS: After the removal of duplicates, 73 websites were assessed, with the majority originating from the United States (n=46, 63%). Overall, the quality of the content was of moderate quality, with a median Ensuring Quality Information for Patients score of 21 (IQR 18-25, maximum 29) out of a maximum possible score of 36. Precautionary measures were not mentioned on 41% (n=30) of websites and 30% (n=22) did not identify disk batteries as a risky FB. Red flags necessitating urgent care were identified on 95% (n=69) of websites, with 89% (n=65) advising patients to seek medical attention and 38% (n=28) advising on safe FB removal. Readability scores (Flesch Reading Ease score=12.4, Flesch-Kincaid Grade Level=6.2, Gunning-Fog Index=6.5, and Simple Measure of Gobbledygook=5.9 years) showed most websites (56%) were below the recommended sixth-grade level.
    CONCLUSIONS: The current quality and readability of information regarding FBs is inadequate. More than half of the websites were above the recommended sixth-grade reading level, and important information regarding high-risk FBs such as disk batteries and magnets was frequently excluded. Strategies should be developed to improve access to high-quality information that informs patients and parents about risks and when to seek medical help. Strategies to promote high-quality websites in search results also have the potential to improve outcomes.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

    求助全文

  • 文章类型: Journal Article
    目的:药物配伍禁忌,药物错误的重要子集,在药物管理阶段威胁患者安全。尽管药物配伍禁忌的患病率很高,目前对此了解甚少,因为以前的研究主要集中在重症监护病房(ICU)设置上.为了提高病人的安全,从全面的角度扩大我们对这个问题的理解至关重要。本研究旨在通过分析医院范围内的处方和管理数据来调查药物配伍禁忌的患病率和机制。
    方法:这项回顾性横断面研究,在三级学术医院进行,包括从研究机构的临床数据仓库中提取的2021年1月1日至2021年5月31日期间收治的患者数据。使用研究现场临床工作流程鉴定药物对(PC)中的潜在接触。每个PC的药物不相容性通过使用商业药物不相容性数据库来确定,Trissel™2临床药物数据库(Trissel2数据库)。确定了药物不相容的驱动因素,基于描述性分析,之后,采用多因素logistic回归分析评估入院时出现一种或多种药物不相容性的危险因素.
    结果:在30,359例患者中(代表40,061例住院),分析了24,270例患者(32,912例住院)和764,501例药物处方(1,001,685例IV给药),检查合格后。根据确定PC的规则,确定了5,813,794例PC。其中,25,108(0.4%)例不兼容的PC:在处方过程中发生了391(1.6%)PC,在给药过程中发生了24,717(98.4%)PC。通过对这些结果进行分类,我们确定了以下导致药物配伍不良的驱动因素:不正确的顺序因素;不正确的给药因素;缺乏相关研究.在多变量分析中,男性患者遇到不相容的PC的风险更高,年长的,更长的停留时间,伴随着更高的合并症,并进入医疗重症监护室。
    结论:我们通过分析医院范围内的药物处方和管理数据,全面描述了药物不兼容的现状。结果表明,在临床环境中经常发生药物不相容。
    OBJECTIVE: Drug incompatibility, a significant subset of medication errors, threaten patient safety during the medication administration phase. Despite the undeniably high prevalence of drug incompatibility, it is currently poorly understood because previous studies are focused predominantly on intensive care unit (ICU) settings. To enhance patient safety, it is crucial to expand our understanding of this issue from a comprehensive viewpoint. This study aims to investigate the prevalence and mechanism of drug incompatibility by analysing hospital-wide prescription and administration data.
    METHODS: This retrospective cross-sectional study, conducted at a tertiary academic hospital, included data extracted from the clinical data warehouse of the study institution on patients admitted between January 1, 2021, and May 31, 2021. Potential contacts in drug pairs (PCs) were identified using the study site clinical workflow. Drug incompatibility for each PC was determined by using a commercial drug incompatibility database, the Trissel\'s™ 2 Clinical Pharmaceutics Database (Trissel\'s 2 database). Drivers of drug incompatibility were identified, based on a descriptive analysis, after which, multivariate logistic regression was conducted to assess the risk factors for experiencing one or more drug incompatibilities during admission.
    RESULTS: Among 30,359 patients (representing 40,061 hospitalisations), 24,270 patients (32,912 hospitalisations) with 764,501 drug prescriptions (1,001,685 IV administrations) were analysed, after checking for eligibility. Based on the rule for determining PCs, 5,813,794 cases of PCs were identified. Among these, 25,108 (0.4 %) cases were incompatible PCs: 391 (1.6 %) PCs occurred during the prescription process and 24,717 (98.4 %) PCs during the administration process. By classifying these results, we identified the following drivers contributing to drug incompatibility: incorrect order factor; incorrect administration factor; and lack of related research. In multivariate analysis, the risk of encountering incompatible PCs was higher for patients who were male, older, with longer lengths of stay, with higher comorbidity, and admitted to medical ICUs.
    CONCLUSIONS: We comprehensively described the current state of drug incompatibility by analysing hospital-wide drug prescription and administration data. The results showed that drug incompatibility frequently occurs in clinical settings.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

    求助全文

  • 文章类型: Journal Article
    COVID-19和结构性种族主义的双重流行病使人们关注健康差异以及疾病对有色人种社区的不成比例的影响。卫生公平随后成为一个优先事项。认识到医疗保健的未来将由包括人工智能(AI)在内的先进信息技术提供信息,机器学习,和算法应用,作者认为,为了朝着改善健康公平的状态前进,健康信息专业人员需要参与和鼓励在健康公平的交叉点进行研究,健康差异,和计算生物医学知识(CBK)应用。建议提供了参与这一动员工作的手段。
    The twin pandemics of COVID-19 and structural racism brought into focus health disparities and disproportionate impacts of disease on communities of color. Health equity has subsequently emerged as a priority. Recognizing that the future of health care will be informed by advanced information technologies including artificial intelligence (AI), machine learning, and algorithmic applications, the authors argue that to advance towards states of improved health equity, health information professionals need to engage in and encourage the conduct of research at the intersections of health equity, health disparities, and computational biomedical knowledge (CBK) applications. Recommendations are provided with a means to engage in this mobilization effort.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Journal Article
    这项研究检查了与健康信息技术相关的事件,以描述系统问题,以此作为改进瑞典临床实践的基础。通过访谈收集了事件报告,并从自愿事件数据库中回顾性收集了事件。使用演绎和归纳法对其进行了分析。大多数主题与系统问题有关,如功能,设计,和融合。发现的系统问题主要由技术因素(74%),而人为因素占26%。超过一半的事件(55%)影响到员工或组织,其余的患者-患者不便(25%)和患者伤害(20%)。调查结果表明,选择和委托合适的系统至关重要,设计出“容易出错”的功能,确保应急计划到位,实施临床决策支持系统,并及时响应事件。这些战略将改善卫生信息技术系统和瑞典临床实践。
    This study examined health information technology-related incidents to characterise system issues as a basis for improvement in Swedish clinical practice. Incident reports were collected through interviews together with retrospectively collected incidents from voluntary incident databases, which were analysed using deductive and inductive approaches. Most themes pertained to system issues, such as functionality, design, and integration. Identified system issues were dominated by technical factors (74%), while human factors accounted for 26%. Over half of the incidents (55%) impacted on staff or the organisation, and the rest on patients - patient inconvenience (25%) and patient harm (20%). The findings indicate that it is vital to choose and commission suitable systems, design out \"error-prone\" features, ensure contingency plans are in place, implement clinical decision-support systems, and respond to incidents on time. Such strategies would improve the health information technology systems and Swedish clinical practice.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

    求助全文

  • 文章类型: Journal Article
    背景:在过去的30年里,美国医学信息学协会(AMIA)在培养生物医学和健康信息学专业人员的协作社区方面发挥了关键作用。作为一个跨学科的协会,AMIA将个人与临床,研究,和计算机专业知识,并强调使用数据来加强生物医学研究和临床工作。在AMIA内部需要一个识别计划,承认成员的应用信息学技能,导致在2018年建立了AMIA(FAMIA)认可计划研究员。
    目的:概述FAMIA计划的演变并阐明其起源,发展,和影响。本报告探讨了导致FAMIA成立的因素,影响其发展的考虑因素,以及FAMIA寻求在AMIA的更广泛背景下实现的目标。
    方法:通过历史镜头检查FAMIA的发展,包括关键的里程碑,讨论,以及塑造程序的决定。通过AMIA成员和领导层内部的讨论,收集了对FAMIA形成的见解,包括提案,董事会级别的讨论,以及关键利益相关者的参与。此外,该报告概述了FAMIA资格标准和可用于认可的途径,即认证途径和长期体验途径。
    结果:FAMIA计划引入了五个课程,共602名研究员。学科概述,角色,并提供了FAMIA成员的申请途径。与相关领域的其他同行认可计划的比较分析显示了FAMIA在承认应用信息学方面的独特功能和贡献。
    结论:现在是第六个年头,FAMIA承认应用信息学在健康信息专业人员中的影响力越来越大,认识有经验的人,培训,并致力于最高水平的应用信息学和与之相关的科学。
    BACKGROUND:  Over the past 30 years, the American Medical Informatics Association (AMIA) has played a pivotal role in fostering a collaborative community for professionals in biomedical and health informatics. As an interdisciplinary association, AMIA brings together individuals with clinical, research, and computer expertise and emphasizes the use of data to enhance biomedical research and clinical work. The need for a recognition program within AMIA, acknowledging applied informatics skills by members, led to the establishment of the Fellows of AMIA (FAMIA) Recognition Program in 2018.
    OBJECTIVE:  To outline the evolution of the FAMIA program and shed light on its origins, development, and impact. This report explores factors that led to the establishment of FAMIA, considerations affecting its development, and the objectives FAMIA seeks to achieve within the broader context of AMIA.
    METHODS:  The development of FAMIA is examined through a historical lens, encompassing key milestones, discussions, and decisions that shaped the program. Insights into the formation of FAMIA were gathered through discussions within AMIA membership and leadership, including proposals, board-level discussions, and the involvement of key stakeholders. Additionally, the report outlines criteria for FAMIA eligibility and the pathways available for recognition, namely the Certification Pathway and the Long-Term Experience Pathway.
    RESULTS:  The FAMIA program has inducted five classes, totaling 602 fellows. An overview of disciplines, roles, and application pathways for FAMIA members is provided. A comparative analysis with other fellow recognition programs in related fields showcases the unique features and contributions of FAMIA in acknowledging applied informatics.
    CONCLUSIONS:  Now in its sixth year, FAMIA acknowledges the growing influence of applied informatics within health information professionals, recognizing individuals with experience, training, and a commitment to the highest level of applied informatics and the science associated with it.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Journal Article
    鉴于医疗服务中技术应用的风险最小化和效益最大化的要求,迫切需要将基于理论的健康IT(HIT)评估框架纳入现有和新兴的人工智能(AI)评估指南。这样的框架可以帮助开发人员,实施者,和战略决策者建立在经验和现有经验证据基础上。我们为选定的具体示例提供了务实的概念概述,说明如何使用现有的基于理论的HIT评估框架来为医疗保健环境中AI的安全开发和实施提供信息。该列表并非详尽无遗,旨在说明符合各种利益相关者要求的应用程序。现有的HIT评估框架可以通过支持开发人员和战略决策者考虑相关技术,帮助为基于AI的开发和实施提供信息。用户,和组织维度。这可以促进技术的设计,它们在用户和组织设置中的实施,以及技术的可持续性和可扩展性。
    Given the requirement to minimize the risks and maximize the benefits of technology applications in health care provision, there is an urgent need to incorporate theory-informed health IT (HIT) evaluation frameworks into existing and emerging guidelines for the evaluation of artificial intelligence (AI). Such frameworks can help developers, implementers, and strategic decision makers to build on experience and the existing empirical evidence base. We provide a pragmatic conceptual overview of selected concrete examples of how existing theory-informed HIT evaluation frameworks may be used to inform the safe development and implementation of AI in health care settings. The list is not exhaustive and is intended to illustrate applications in line with various stakeholder requirements. Existing HIT evaluation frameworks can help to inform AI-based development and implementation by supporting developers and strategic decision makers in considering relevant technology, user, and organizational dimensions. This can facilitate the design of technologies, their implementation in user and organizational settings, and the sustainability and scalability of technologies.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

    求助全文

  • 文章类型: Journal Article
    在过去的25年里,在线学习的价值和方法发生了巨大的变化。本文的目标是回顾作者在生物医学和健康信息学领域的25年在线学习经验,描述学习者的服务和经验教训。作者详细介绍了在信息学中进行在线教育的决定的历史,描述了随着教育技术的发展而采取的方法。已经为大量的学习者提供了服务,在线学习方法受到了欢迎,有许多经验教训,以优化教育经验。生物医学和健康信息学的在线教育为该领域的学习提供了可扩展的示例性方法。
    The value and methods of online learning have changed tremendously over the last 25 years. The goal of this paper is to review a quarter-century of experience with online learning by the author in the field of biomedical and health informatics, describing the learners served and the lessons learned. The author details the history of the decision to pursue online education in informatics, describing the approaches taken as educational technology evolved over time. A large number of learners have been served, and the online learning approach has been well-received, with many lessons learned to optimize the educational experience. Online education in biomedical and health informatics has provided a scalable and exemplary approach to learning in this field.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

    求助全文

公众号