BACKGROUND: Although uncertainties exist regarding implementation, artificial intelligence-driven generative language models (GLMs) have enormous potential in medicine. Deployment of GLMs could improve patient comprehension of clinical texts and improve low health literacy.
OBJECTIVE: The goal of this study is to evaluate the potential of ChatGPT-3.5 and GPT-4 to tailor the complexity of medical information to patient-specific input education level, which is crucial if it is to serve as a tool in addressing low health literacy.
METHODS: Input templates related to 2 prevalent chronic diseases-type II diabetes and hypertension-were designed. Each clinical vignette was adjusted for hypothetical patient education levels to evaluate output personalization. To assess the success of a GLM (GPT-3.5 and GPT-4) in tailoring output writing, the readability of pre- and posttransformation outputs were quantified using the Flesch reading ease score (FKRE) and the Flesch-Kincaid grade level (FKGL).
RESULTS: Responses (n=80) were generated using GPT-3.5 and GPT-4 across 2 clinical vignettes. For GPT-3.5, FKRE means were 57.75 (SD 4.75), 51.28 (SD 5.14), 32.28 (SD 4.52), and 28.31 (SD 5.22) for 6th grade, 8th grade, high school, and bachelor\'s, respectively; FKGL mean scores were 9.08 (SD 0.90), 10.27 (SD 1.06), 13.4 (SD 0.80), and 13.74 (SD 1.18). GPT-3.5 only aligned with the prespecified education levels at the bachelor\'s degree. Conversely, GPT-4\'s FKRE mean scores were 74.54 (SD 2.6), 71.25 (SD 4.96), 47.61 (SD 6.13), and 13.71 (SD 5.77), with FKGL mean scores of 6.3 (SD 0.73), 6.7 (SD 1.11), 11.09 (SD 1.26), and 17.03 (SD 1.11) for the same respective education levels. GPT-4 met the target readability for all groups except the 6th-grade FKRE average. Both GLMs produced outputs with statistically significant differences (P<.001; 8th grade P<.001; high school P<.001; bachelors P=.003; FKGL: 6th grade P=.001; 8th grade P<.001; high school P<.001; bachelors P<.001) between mean FKRE and FKGL across input education levels.
CONCLUSIONS: GLMs can change the structure and readability of medical text outputs according to input-specified education. However, GLMs categorize input education designation into 3 broad tiers of output readability: easy (6th and 8th grade), medium (high school), and difficult (bachelor\'s degree). This is the first result to suggest that there are broader boundaries in the success of GLMs in output text simplification. Future research must establish how GLMs can reliably personalize medical texts to prespecified education levels to enable a broader impact on health care literacy.

BACKGROUND: In recent years, academics have increasingly acknowledged the importance of involving health service users and community stakeholders as active partners in health research. Yet, the involvement of older adults, the largest group of health service users, as research partners remains limited, possibly due to ageist attitudes that devalue older adults\' contributions. During the three years of our Awakening Canadians to Ageism study, we convened an advisory group consisting of older adults and gerontological experts to discuss issues related to ageism, help interpret the study findings, and develop a range of knowledge mobilization strategies to dispel ageism.
METHODS: To understand the experiences of members of the advisory group and solicit recommendations for improving future groups, we conducted a qualitative descriptive study and interviewed 8 older adults and 6 gerontological experts. Data were content analyzed.
RESULTS: Four categories that were developed to explain participants\' experiences and suggestions for future advisory groups included: organization and management, group experience, suggestions for future advisory groups and moving forward. A key finding was the value that the older adults and gerontological experts ascribed to conversations about the prevalence of ageism and their desire to continue these types of conversations in their personal groups and professional networks. Numerous helpful strategies for future advisory groups were identified, such as enhancing social diversity, both in terms of racial/ethnic/cultural representation and gender. Older adults wanted more \"getting to know you time\" in meetings and gerontological experts wanted more details about the research process and their role.
CONCLUSIONS: This study\'s partnership approach can guide researchers seeking to involve key health service users and community stakeholders in health research and help enact positive social change.
In 2022 we developed an advisory group consisting of older adults and gerontological experts to review the findings of the first stage of our study Awakening Canadians to Ageism and provide guidance on knowledge mobilization and next steps. We interviewed 12 older adults and 6 gerontological experts from our advisory group to learn about their experiences with the group and provide suggestions for future groups. Participants provided feedback on group organization, management and processes, in addition to their experiences and strategies for future advisory groups. Both groups suggested enhancing the social diversity of the group, both in terms of racial/ethnic/cultural representation and gender. Older adults wanted more meeting time dedicated to getting to know the other groups members and gerontological experts wanted more details about the research process and their role.

BACKGROUND: Communication is a multifaceted process, ranging from linear, one-way approaches, such as transmitting a simple message, to continuous exchanges and feedback loops among stakeholders. In particular the COVID-19 pandemic underscored the critical need for timely, effective and credible evidence communication to increase awareness, levels of trust, and evidence uptake in policy and practice. However, whether to improve policy responses in crises or address more commonplace societal challenges, comprehensive guidance on evidence communication to decision-makers in health policies and systems remains limited. Our objective was to identify and systematize the global evidence on frameworks, guidance and tools supporting effective communication of research evidence to facilitate knowledge translation and evidence-informed policy-making processes, while also addressing barriers and facilitators.
METHODS: We conducted a rapid scoping review following the Joanna Briggs Manual. Literature searches were performed across eight indexed databases and two sources of grey literature, without language or time restrictions. The methodological quality of included studies was assessed, and a narrative-interpretative synthesis was applied to present the findings.
RESULTS: We identified 16 documents presenting either complete frameworks or framework components, including guidance and tools, aimed at supporting evidence communication for policy development. These frameworks outlined strategies, theoretical models, barriers and facilitators, as well as insights into policy-makers\' perspectives, communication needs, and preferences. Three primary evidence communication strategies, comprising eleven sub-strategies, emerged: \"Health information packaging\", \"Targeting and tailoring messages to the audience\", and \"Combined communication strategies\". Based on the documented barriers and facilitators at micro, meso and macro levels, critical factors for successful communication of evidence to policy-makers were identified.
CONCLUSIONS: Effective communication is indispensable for facilitating knowledge translation and evidence-informed policy-making. Nonetheless gaps persist in frameworks designed to enhance research communication to policy-makers, particularly regarding the effectiveness of multiple communication strategies. To advance in this field, the development of comprehensive frameworks incorporating implementation strategies is warranted. Additionally, barriers and facilitators to implementing effective communication must be recognized and addressed taking diverse contexts into consideration. Registration https://zenodo.org/record/5578550.

UNASSIGNED: Chronic pain among athletes is often misinterpreted as tissue damage resulting from sport. While researchers have started to examine neuropathic pain among athletes with spinal cord injury (SCI), there is a need to develop a deeper understanding of their neuropathic pain symptoms and experiences, to support the development of evidence-based pain management protocols.
UNASSIGNED: The primary purpose of this study was to describe neuropathic pain experienced by athletes with SCI. A secondary purpose was to compare athletes\' neuropathic pain symptoms when measured by two different clinical pain assessment tools and describe their experiences when trying to communicate their neuropathic pain.
UNASSIGNED: 47 athletes with SCI completed the International Spinal Cord Injury Pain Basic Data Set (V.2.0), Douleur Neuropathique 4 (DN4), and two open-ended pain questions over the telephone.
UNASSIGNED: 66% of participants reported experiencing moderate-intensity neuropathic pain (Mpain intensity=5.32±1.78) and mild-to-moderate pain interference with activities of daily living (Mpain interference=3.55±2.11) and sleep (Mpain interference4.68±2.92). Overall, participants reported significantly more neuropathic pain symptoms in response to DN4 questions (M=4.62±1.38) versus open-ended pain questions (M=2.13±1.08), p<0.001. Participants reported difficulty with identifying neuropathic pain, describing their pain symptoms and identifying pain locations.
UNASSIGNED: Athletes with SCI reported moderate-intensity neuropathic pain. However, they struggled with communicating their neuropathic pain without being prompted with a list of symptoms. To guide the development of effective pain management strategies among athletes with SCI, future research should focus on developing knowledge products to improve awareness of common neuropathic pain descriptors among athletes with SCI and sports medicine personnel.

OBJECTIVE: To describe a knowledge translation capacity-building initiative and illustrate the roles of nurses in practice change using an exemplar case study.
METHODS: The report uses observational methods and reflection.
METHODS: The Knowledge Translation Challenge program involves a multi-component intervention across several sites. The advisory committee invited eligible teams to attend capacity-building workshops. Implementation plans were developed, and successful teams receive funding for a 2 year period. Evaluation involved collecting data on program uptake and impact on practice change. Data has been collected from five cohorts. The exemplar case study employed an action-research framework.
RESULTS: Four nurse-led teams have demonstrated successful implementation of their practice change. The case study on implementing a clinical toolkit for clozapine management further illustrates a thoughtful planning process, and implementation journey and learnings by a team of nurses.
CONCLUSIONS: The Knowledge Translation Challenge program empowers nurses to use implementation science practices to enhance the quality and effectiveness of healthcare services. Success of this initiative serves as a model for addressing the persistent gap between knowledge and practice in clinical settings and the value of activating nurses to help close this gap.
CONCLUSIONS: As the most trusted and numerous profession, it is vital that nurses contribute to efforts to translate research evidence into clinical practice. The Knowledge Translation Challenge program supports nurses to lead practice change.
CONCLUSIONS: The Knowledge Translation Challenge program successfully equips nurses and other health care providers with the knowledge, skills and resources to implement practice improvements which enhance the quality and effectiveness of healthcare services and nursing practice.
UNASSIGNED: The Knowledge Translation Challenge advisory committee has three patient-public partners that support teams to develop a patient-oriented approach for their projects by providing feedback on the implementation plans. Each team was also supported to include patient-public partners on their project.

Interprofessional collaboration in palliative care is essential to ensuring high-quality care for seriously ill patients. Education interventions to increase competency in palliative care should incorporate team-building skills to encourage an interprofessional approach. We developed and piloted a virtual educational program named CAPACITI for interprofessional teams to promote a community palliative approach to care. Primary care teams from across Ontario, Canada, participated in CAPACITI which consisted of 10 facilitated sessions that emphasized how to operationalize a palliative care approach as a team. Pre- and post-study questionnaires were completed by each team, including the AITCS-II, a validated instrument that measures interprofessional collaboration. We analyzed individual paired differences in summary scores and in each of three subdomains of the AITCS-II questionnaire: partnership, cooperation, and coordination. Seventeen teams completed the AITCS-II post survey, representing 133 participants. Teams varied demographically and ranged from 5 to 16 members. After CAPACITI, the overall mean AITCS-II summary score among teams increased to 96.0 (SD = 10.0) for a significant paired mean difference increase of 9.4 (p = .03). There were also significant increases in the partnership (p = .01) and in the cooperation subdomains (p = .04). CAPACITI demonstrated the potential for improving collaboration among primary care teams, which can lead to improved provider and patient outcomes in palliative care.

METHODS: Mathematical modelling played an important role in the public health response to COVID-19 in Canada. Variability in epidemic trajectories, modelling approaches, and data infrastructure across provinces provides a unique opportunity to understand the factors that shaped modelling strategies.
METHODS: Provinces implemented stringent pandemic interventions to mitigate SARS-CoV-2 transmission, considering evidence from epidemic models. This study aimed to summarize provincial COVID-19 modelling efforts. We identified modelling teams working with provincial decision-makers, through referrals and membership in Canadian modelling networks. Information on models, data sources, and knowledge translation were abstracted using standardized instruments.
RESULTS: We obtained information from six provinces. For provinces with sustained community transmission, initial modelling efforts focused on projecting epidemic trajectories and healthcare demands, and evaluating impacts of proposed interventions. In provinces with low community transmission, models emphasized quantifying importation risks. Most of the models were compartmental and deterministic, with projection horizons of a few weeks. Models were updated regularly or replaced by new ones, adapting to changing local epidemic dynamics, pathogen characteristics, vaccines, and requests from public health. Surveillance datasets for cases, hospitalizations and deaths, and serological studies were the main data sources for model calibration. Access to data for modelling and the structure for knowledge translation differed markedly between provinces.
CONCLUSIONS: Provincial modelling efforts during the COVID-19 pandemic were tailored to local contexts and modulated by available resources. Strengthening Canadian modelling capacity, developing and sustaining collaborations between modellers and governments, and ensuring earlier access to linked and timely surveillance data could help improve pandemic preparedness.
RéSUMé: CONTEXTE: La modélisation mathématique a joué un rôle de premier plan dans les ripostes sanitaires à la COVID-19 au Canada. Les différentes trajectoires épidémiques provinciales, leurs approches de modélisation et infrastructures de données représentent une occasion unique de comprendre les facteurs qui ont influencé les stratégies de modélisation provinciales. INTERVENTION: Les provinces ont mis en place des mesures de santé publique strictes afin d’atténuer la transmission du SRAS-CoV-2 en tenant compte des données probantes provenant des modèles épidémiques. Notre étude vise à décrire et résumer les efforts provinciaux de modélisation de la COVID-19. Nous avons identifié les équipes de modélisation travaillant avec les décideurs provinciaux parmi les réseaux Canadiens de modélisation et par référence. Les informations sur les modèles, leurs sources de données et les approches de mobilisation des connaissances ont été obtenues à l’aide d’instruments standardisés. RéSULTATS: Nous avons colligé les informations provenant de six provinces. Pour les provinces qui ont eu de la transmission communautaire soutenue, les efforts de modélisation initiaux se sont concentrés sur la projection des trajectoires épidémiques et des demandes de soins de santé et sur l’évaluation des impacts des interventions proposées. Dans les provinces où la transmission communautaire a été faible, les modèles visaient à quantifier les risques d’importation. La plupart des équipes ont développé des modèles à compartiments déterministes avec des horizons de projection de quelques semaines. Les modèles ont été régulièrement mis à jour ou remplacés par de nouveaux, s’adaptant aux dynamiques locales, à l’arrivée de nouveaux variants, aux vaccins et aux demandes des autorités de santé publique. Les données de surveillance des cas, des hospitalisations et des décès, ainsi que les études sérologiques, ont constitué les principales sources de données pour calibrer les modèles. L’accès aux données pour la modélisation et la structure de mobilisation des connaissances différaient considérablement d’une province à l’autre. IMPLICATION: Les efforts de modélisation provinciaux pendant la pandémie de la COVID-19 ont été adaptés aux contextes locaux et modulés par les ressources disponibles. Le renforcement de la capacité canadienne de modélisation, le développement et le maintien de collaborations entre les modélisateurs et les gouvernements, ainsi qu’un accès rapide et opportun aux données de surveillance individuelles et liées pourraient contribuer à améliorer la préparation aux futures pandémies.

Clinical informatics (CI) competencies are crucial for health care organizations to effectively use information communication technologies (ICTs) and deliver quality care. An interdisciplinary CI team can assist organizations with leveraging ICTs, but may also require support. This case study describes a peer-led knowledge translation project designed, delivered and implemented over two years by members of the CI team at Providence Health Care (PHC). The project included CI competencies assessment of CI team members, followed by tailored education for identified knowledge gaps. The Kirkpatrick evaluation model was used to assess three levels of learning among CI team members, including a satisfaction survey, pre-and post-cognitive retention of the education intervention using a validated tool for informatics specialists, and project partner feedback of CI team performance 12 weeks after education completion. This case study provides evidence-informed guidance on \'how to\' implement peer-led, practice-based CI training for CI teams.

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UNASSIGNED: Forty percent of individuals within the Disorders of Consciousness (DoC) spectrum are misdiagnosed as in a vegetative state/unresponsive wakefulness syndrome (VS/UWS) when in fact they are minimally conscious or emerged, underscoring a need to optimize evaluation techniques and interprofessional care management.
UNASSIGNED: Conscious Care is a proposed care model that aims to improve interprofessional care of patients with DoC in the hospital setting. The aim of this paper is to describe this model\'s key ingredients and various components.
UNASSIGNED: This care model will advance clinician and caregiver preparedness to manage the complexities of this population and advocate for equal access to post-hospital medical and rehabilitative services. Evaluation and treatment of survivors of DoC should incorporate current evidence which drives continuous quality improvement and education to clinicians across the continuum of care. Immediate action must be taken to decrease the vulnerability and neglect of this marginalized population. Conscious Care is an innovative, sustainable solution that will improve interprofessional awareness of best practices and available science, strengthen care, and advocate for the right to quality of life that this population is so often denied.