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Tieosapjaroen W, Chen E, Ritchwood T, Li C, Conklin JL, Babatunde AO, Ongkeko AM, Nwaozuru U, Tucker JD, Castillo Carandang NT, Ong JJ. Designathons in health research: a global systematic review. BMJ Glob Health 2024; 9:e013961. [PMID: 38453248 PMCID: PMC10921519 DOI: 10.1136/bmjgh-2023-013961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Accepted: 01/16/2024] [Indexed: 03/09/2024] Open
Abstract
INTRODUCTION A designathon is a three-stage participatory activity informed by design thinking. There is a growing literature on designathons in health. This study synthesised designathons' effectiveness and implementation-related factors to address health challenges. METHODS We searched Cochrane Library, Embase, PubMed, Scopus and the ClinicalTrials.gov registry for articles containing primary data on designathons for health from their dates of inception to 29 November 2022. We retrieved additional studies from citation searching and a complementary open call. We synthesised data on designathons' effectiveness (ie, engagement, outputs and implementation), required resources and implementation-related factors (ie, resources, facilitators, barriers, strengths and limitations). We assessed the risk of bias using a checklist adapted from Joanna Briggs Institute Critical Appraisal tools. RESULTS In total, 4973 citations were identified, and 42 studies were included. In total, 26 studies (62%) were from high-income countries. The median number of total participants was 49, divided into a median of 8 teams. The duration of the intensive collaboration phase ranged from 3 hours to 7 days. Common evaluation criteria were feasibility, innovation and impact. Idea and prototype outputs included mobile phone applications, educational programmes and medical devices. Interventions developed from a designathon was estimated to be highly cost-effective. The most common facilitators were interdisciplinary participants and high-quality mentorship. The most common barriers were suboptimal execution of the events, difficulties in balancing interdisciplinary participants across teams and limited support for participants along the process. There were limited data on required resources and further implementation of solutions after designathons. CONCLUSION Given designathons' adaptability in terms of budget, mode of delivery, type of output and involvement of diverse participants, including end users, designathons can be implemented in a wide range of contexts to address various health issues. PROSPERO REGISTRATION NUMBER CRD42023389685.
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Affiliation(s)
- Warittha Tieosapjaroen
- Melbourne Sexual Health Centre, Alfred Health, Carlton, Victoria, Australia
- Central Clinical School, Monash University, Melbourne, Victoria, Australia
| | - Elizabeth Chen
- Department of Health Behavior, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Tiarney Ritchwood
- Department of Family Medicine and Community Health, Duke University School of Medicine, Durham, North Carolina, USA
| | - Chunyan Li
- Tokyo College, The University of Tokyo, Tokyo, Japan
| | - Jamie L Conklin
- Health Sciences Library, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | | | - Arturo M Ongkeko
- National Institutes of Health, University of the Philippines Manila, Manila, The Philippines
- Foundation for the Advancement of Clinical Epidemiology Inc, Manila, The Philippines
| | - Ucheoma Nwaozuru
- Department of Implementation Science, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Joseph D Tucker
- Institute for Global Health and Infectious Diseases, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Clinical Research Department, London School of Hygiene and Tropical Medicine, London, UK
| | - Nina T Castillo Carandang
- Foundation for the Advancement of Clinical Epidemiology Inc, Manila, The Philippines
- Department of Clinical Epidemiology, University of the Philippines Manila, Manila, The Philippines
| | - Jason J Ong
- Melbourne Sexual Health Centre, Alfred Health, Carlton, Victoria, Australia
- Central Clinical School, Monash University, Melbourne, Victoria, Australia
- Clinical Research Department, London School of Hygiene and Tropical Medicine, London, UK
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Agha-Mir-Salim L, McCullum L, Dähnert E, Scheel YD, Wilson A, Carpio M, Chan C, Lo C, Maher L, Dressler C, Balzer F, Celi LA, Poncette AS, Pelter MM. Interdisciplinary collaboration in critical care alarm research: A bibliometric analysis. Int J Med Inform 2024; 181:105285. [PMID: 37977055 DOI: 10.1016/j.ijmedinf.2023.105285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 08/30/2023] [Accepted: 11/02/2023] [Indexed: 11/19/2023]
Abstract
BACKGROUND Alarm fatigue in nurses is a major patient safety concern in the intensive care unit. This is caused by exposure to high rates of false and non-actionable alarms. Despite decades of research, the problem persists, leading to stress, burnout, and patient harm resulting from true missed events. While engineering approaches to reduce false alarms have spurred hope, they appear to lack collaboration between nurses and engineers to produce real-world solutions. The aim of this bibliometric analysis was to examine the relevant literature to quantify the level of authorial collaboration between nurses, physicians, and engineers. METHODS We conducted a bibliometric analysis of articles on alarm fatigue and false alarm reduction strategies in critical care published between 2010 and 2022. Data were extracted at the article and author level. The percentages of author disciplines per publication were calculated by study design, journal subject area, and other article-level factors. RESULTS A total of 155 articles with 583 unique authors were identified. While 31.73 % (n = 185) of the unique authors had a nursing background, publications using an engineering study design (n = 46), e.g., model development, had a very low involvement of nursing authors (mean proportion at 1.09 %). Observational studies (n = 58) and interventional studies (n = 33) had a higher mean involvement of 52.27 % and 47.75 %, respectively. Articles published in nursing journals (n = 32) had the highest mean proportion of nursing authors (80.32 %), while those published in engineering journals (n = 46) had the lowest (9.00 %), with 6 (13.04 %) articles having one or more nurses as co-authors. CONCLUSION Minimal involvement of nursing expertise in alarm research utilizing engineering methodologies may be one reason for the lack of successful, real-world solutions to ameliorate alarm fatigue. Fostering a collaborative, interdisciplinary research culture can promote a common publication culture across fields and may yield sustainable implementation of technological solutions in healthcare.
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Affiliation(s)
- Louis Agha-Mir-Salim
- Institute of Medical Informatics, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.
| | - Lucas McCullum
- Department of Imaging Physics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Enrico Dähnert
- Hospital Management, Nursing Directorate, Practice Development and Nursing Science, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Yanick-Daniel Scheel
- Hospital Management, Nursing Directorate, Practice Development and Nursing Science, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Ainsley Wilson
- Department of Nursing, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Marianne Carpio
- Medical Intensive Care Unit, Boston Children's Hospital, Boston, MA, USA
| | - Carmen Chan
- School of Nursing and Health Professions, University of San Francisco, San Francisco, CA, USA
| | - Claudia Lo
- School of Nursing and Health Professions, University of San Francisco, San Francisco, CA, USA; Department of Business Analytics and Information Systems, School of Management, University of San Francisco, San Francisco, CA, USA
| | - Lindsay Maher
- School of Nursing and Health Professions, University of San Francisco, San Francisco, CA, USA
| | - Corinna Dressler
- Medical Library, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Felix Balzer
- Institute of Medical Informatics, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Leo Anthony Celi
- Institute for Medical Engineering and Science, Massachusetts Institute of Technology, Cambridge, MA, USA; Department of Medicine, Beth Israel Deaconess Medical Center, Beth Israel Deaconess Medical Center, Boston, MA, USA; Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Akira-Sebastian Poncette
- Institute of Medical Informatics, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany; Department of Anesthesiology and Intensive Care Medicine, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Michele M Pelter
- Department of Physiological Nursing, University of California San Francisco School of Nursing, San Francisco, CA, USA
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Rigas ES, Kostomanolakis S, Kyriakoulakos N, Kounalakis D, Petrakis I, Berler A, Boumpaki A, Karanikas H, Kelepouris A, Bamidis PD, Katehakis DG. A hackathon as a tool to enhance research and practice on electronic health record systems' interoperability for chronic disease management and prevention. Front Digit Health 2023; 5:1275711. [PMID: 38034906 PMCID: PMC10682770 DOI: 10.3389/fdgth.2023.1275711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Accepted: 10/20/2023] [Indexed: 12/02/2023] Open
Abstract
Objectives The development of a standardized technical framework for exchanging electronic health records is widely recognized as a challenging endeavor that necessitates appropriate technological, semantic, organizational, and legal interventions to support the continuity of health and care. In this context, this study delineates a pan-European hackathon aimed at evaluating the efforts undertaken by member states of the European Union to develop a European electronic health record exchange format. This format is intended to facilitate secure cross-border healthcare and optimize service delivery to citizens, paving the way toward a unified European health data space. Methods The hackathon was conducted within the scope of the X-eHealth project. Interested parties were initially presented with a representative clinical scenario and a set of specifications pertaining to the European electronic health record exchange format, encompassing Laboratory Results Reports, Medical Imaging and Reports, and Hospital Discharge Reports. In addition, five onboarding webinars and two professional training events were organized to support the participating entities. To ensure a minimum acceptable quality threshold, a set of inclusion criteria for participants was outlined for the interested teams. Results Eight teams participated in the hackathon, showcasing state-of-the-art applications. These teams utilized technologies such as Health Level Seven-Fast Healthcare Interoperability Resources (HL7 FHIR) and Clinical Document Architecture (CDA), alongside pertinent IHE integration profiles. They demonstrated a range of complementary uses and practices, contributing substantial inputs toward the development of future-proof electronic health record management systems. Conclusions The execution of the hackathon demonstrated the efficacy of such approaches in uniting teams from diverse backgrounds to develop state-of-the-art applications. The outcomes produced by the event serve as proof-of-concept demonstrators for managing and preventing chronic diseases, delivering value to citizens, companies, and the research community.
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Affiliation(s)
- Emmanouil S. Rigas
- Lab of Medical Physics and Digital Innovation, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Stavros Kostomanolakis
- Center for eHealth Applications and Services, Institute of Computer Science, FORTH, Heraklion, Greece
| | | | | | - Ioannis Petrakis
- Center for eHealth Applications and Services, Institute of Computer Science, FORTH, Heraklion, Greece
| | | | | | - Haralampos Karanikas
- Department of Computer Science and Biomedical Informatics, University of Thessaly, Lamia, Greece
| | | | - Panagiotis D. Bamidis
- Lab of Medical Physics and Digital Innovation, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Dimitrios G. Katehakis
- Center for eHealth Applications and Services, Institute of Computer Science, FORTH, Heraklion, Greece
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Ghedira K, Dallali H, Ardhaoui M, Bouslema Z, Hamdi Y, Feki Ben-Salah S, Chelbi H, Atri C, Chaouch M, Dekhil N, Rais A, Azouz S, Gharbi M, Guerfali F, Hkimi C, Kamoun S, Ksouri A, Moumni I, Ouragini H, Bsibes R, Afifi Z, Youssfi K, Ben Hassine H, Hadhri N, Mardassi H, Othman H, Khamessi O. PHINDaccess Hackathons for COVID-19 and Host-Pathogen Interaction: Lessons Learned and Recommendations for Low- and Middle-Income Countries. BIOMED RESEARCH INTERNATIONAL 2023; 2023:6638714. [PMID: 37854792 PMCID: PMC10581832 DOI: 10.1155/2023/6638714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/15/2023] [Revised: 08/29/2023] [Accepted: 09/01/2023] [Indexed: 10/20/2023]
Abstract
Hackathons are collaborative events that bring together diverse groups to solve predefined challenges. The COVID-19 pandemic caused by SARS-CoV-2 has emphasized the need for portable and reproducible genomics analysis pipelines to study the genetic susceptibility of the human host and investigate human-SARS-CoV-2 protein interactions. To build and strengthen institutional capacities in OMICS data analysis applied to host-pathogen interaction (HPI), the PHINDaccess project organized two hackathons in 2020 and 2021. These hackathons are aimed at developing bioinformatics pipelines related to the SARS-CoV-2 viral genome, its phylodynamic transmission, and the identification of human genome host variants, with a focus on addressing global health challenges, particularly in low- and middle-income countries (LMIC). This paper outlines the preparation, proceedings, and lessons learned from these hackathons, including the challenges faced by participants and our recommendations based on our experience for organizing hackathons in LMIC and beyond.
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Affiliation(s)
- Kais Ghedira
- Laboratory of Bioinformatics, Biomathematics and Biostatistics LR20IPT09, Pasteur Institute of Tunis, University of Tunis El Manar, Tunis 1002, Tunisia
| | - Hamza Dallali
- Laboratory of Biomedical Genomics and Oncogenetics (LR20IPT05), Pasteur Institute of Tunis, University of Tunis El Manar, Tunis 1002, Tunisia
| | - Monia Ardhaoui
- Department of Human and Experimentally Anatomic Pathology, Laboratory of Molecular Epidemiology and Experimental Pathology, Institut Pasteur de Tunis, University of Tunis El Manar, Tunis, Tunisia
- Laboratory of Molecular Epidemiology and Experimental Pathology, Tunisia
| | - Zied Bouslema
- Laboratory for Rabies Diagnostics, Institute Pasteur of Tunis, Belvedere, Tunis 1002, Tunisia
- University of Tunis El Manar, Tunis, Tunisia
| | - Yosr Hamdi
- Laboratory of Biomedical Genomics and Oncogenetics (LR20IPT05), Pasteur Institute of Tunis, University of Tunis El Manar, Tunis 1002, Tunisia
| | - Salma Feki Ben-Salah
- Laboratory of Virus, Vector and Hosts (LR20IPT02), Institut Pasteur de Tunis, Université Tunis El Manar, Tunis 1068, Tunisia
| | - Hanen Chelbi
- Laboratory of Medical Parasitology, Biotechnology and Biomolecules, LR16IPT06, Institut Pasteur de Tunis, Université Tunis El Manar, Tunis Belvédère 1002, Tunisia
| | - Chiraz Atri
- Laboratory of Transmission, Control and Immunobiology of Infections (LTCII), LR16IPT02, Institut Pasteur de Tunis, Université Tunis El Manar, Tunis Belvédère 1002, Tunisia
| | - Melek Chaouch
- Laboratory of Bioinformatics, Biomathematics and Biostatistics LR20IPT09, Pasteur Institute of Tunis, University of Tunis El Manar, Tunis 1002, Tunisia
| | - Naira Dekhil
- Laboratory of Molecular Microbiology, Vaccinology, And Biotechnology Development, Institut Pasteur de Tunis, Université Tunis El Manar, Tunis, Tunisia
| | - Afef Rais
- Laboratory of Transmission, Control and Immunobiology of Infections (LTCII), LR16IPT02, Institut Pasteur de Tunis, Université Tunis El Manar, Tunis Belvédère 1002, Tunisia
| | - Saifeddine Azouz
- Genomics Platform, Institut Pasteur de Tunis, Université Tunis El Manar, Tunis 1068, Tunisia
| | - Manel Gharbi
- Laboratory of Epidemiology and Veterinary Microbiology. Group of Bacteriology and Biotechnology Institut Pasteur of Tunisia, University of Tunis El Manar (UTM), Tunis 1002, Tunisia
| | - Fatma Guerfali
- Laboratory of Transmission, Control and Immunobiology of Infections (LTCII), LR16IPT02, Institut Pasteur de Tunis, Université Tunis El Manar, Tunis Belvédère 1002, Tunisia
| | - Chaima Hkimi
- Laboratory of Bioinformatics, Biomathematics and Biostatistics LR20IPT09, Pasteur Institute of Tunis, University of Tunis El Manar, Tunis 1002, Tunisia
| | - Selim Kamoun
- Laboratory of Bioinformatics, Biomathematics and Biostatistics LR20IPT09, Pasteur Institute of Tunis, University of Tunis El Manar, Tunis 1002, Tunisia
| | - Ayoub Ksouri
- Laboratory of Venom, Toxins and Therapeutic Molecules, Institut Pasteur Tunis, University Tunis El Manar, Tunis, Tunisia
| | - Imen Moumni
- Laboratory of Molecular and Cellular Hematology, LR16IPT07, Pasteur Institute of Tunis, University of Tunis El Manar, Tunisia
| | - Houyem Ouragini
- Laboratory of Molecular and Cellular Hematology, LR16IPT07, Pasteur Institute of Tunis, University of Tunis El Manar, Tunisia
| | - Raghda Bsibes
- Grant Office, Institut Pasteur de Tunis, Tunis, Tunisia
| | - Zeineb Afifi
- Grant Office, Institut Pasteur de Tunis, Tunis, Tunisia
| | - Khouloud Youssfi
- Specialized Unit “Communication, Science and Society”, Institut Pasteur de Tunis, Tunis, Tunisia
| | - Hichem Ben Hassine
- Specialized Unit “Communication, Science and Society”, Institut Pasteur de Tunis, Tunis, Tunisia
| | - Najet Hadhri
- Grant Office, Institut Pasteur de Tunis, Tunis, Tunisia
| | - Helmi Mardassi
- Laboratory of Molecular Microbiology, Vaccinology, And Biotechnology Development, Institut Pasteur de Tunis, Université Tunis El Manar, Tunis, Tunisia
| | - Houcemeddine Othman
- Sydney Brenner Institute for Molecular Bioscience, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- Department of Genetics, Farhat Hached University Hospital, Sousse, Tunisia
- Laboratory of Cytogenetics, Molecular Genetics, and Reproductive Biology (LR03SP02), Farhat Hached University Hospital, Sousse, Tunisia
| | - Oussema Khamessi
- Laboratory of Venoms and Therapeutic Molecules LR11IPT08, Institut Pasteur de Tunis, University of Tunis El Manar, 13 Place Pasteur BP74Belvédère, Tunis Belvédère, Tunisia
- High Institute of Biotechnology of Sidi Thabet, University of Manouba, Ariana BP-66, Manouba 2010, Tunisia
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Tahlil KM, Nwaozuru U, Conserve DF, Onyeama UF, Ojo V, Day S, Ong JJ, Tang W, Rosenberg NE, Gbajabiamila T, Nkengasong S, Obiezu-Umeh C, Oladele D, Iwelunmor J, Ezechi O, Tucker JD. Crowdsourcing to support training for public health: A scoping review. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0002202. [PMID: 37494311 PMCID: PMC10370701 DOI: 10.1371/journal.pgph.0002202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Accepted: 06/29/2023] [Indexed: 07/28/2023]
Abstract
Crowdsourcing is an interactive process that has a group of individuals attempt to solve all or part of a problem and then share solutions with the public. Crowdsourcing is increasingly used to enhance training through developing learning materials and promoting mentorship. This scoping review aims to assess the literature on crowdsourcing for training in public health. We searched five medical and public health research databases using terms related to crowdsourcing and training. For this review, the concept of crowdsourcing included open calls, designathons, and other activities. We used a PRISMA checklist for scoping reviews. Each full-text was assessed by two independent reviewers. We identified 4,071 citations, and 74 studies were included in the scoping review. This included one study in a low-income country, 15 studies in middle-income countries, 35 studies in high-income countries, and 11 studies conducted in multiple countries of varying income levels (the country income level for 12 studies could not be ascertained). Nine studies used open calls, 35 used a hackathon, designathon or other "a-thon" event, and 30 used other crowdsourcing methods, such as citizen science programs and online creation platforms. In terms of crowdsourcing purpose, studies used crowdsourcing to educate participants (20 studies), develop learning materials (17 studies), enhance mentorship (13 studies) and identify trainees (9 studies). Fifteen studies used crowdsourcing for more than one training purpose. Thirty-four studies were done in-person, 31 were conducted virtually and nine used both meeting options for their crowdsourcing events. Seventeen studies generated open access materials. Our review found that crowdsourcing has been increasingly used to support public health training. This participatory approach can be a useful tool for training in a variety of settings and populations. Future research should investigate the impact of crowdsourcing on training outcomes.
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Affiliation(s)
- Kadija M. Tahlil
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Ucheoma Nwaozuru
- Department of Implementation Science, Wake Forest University School of Medicine, Winston-Salem, North Carolina, United States of America
| | - Donaldson F. Conserve
- Department of Prevention and Community Health, Milken Institute School of Public Health, The George Washington University, Washington, District of Columbia, United States of America
| | - Ujunwa F. Onyeama
- Department of Health Behavior, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Victor Ojo
- Clinical Sciences Department, Nigerian Institute of Medical Research, Lagos, Nigeria
| | - Suzanne Day
- Department of Medicine, Division of Infectious Diseases, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Jason J. Ong
- Central Clinical School, Monash University, Melbourne, Australia
- Melbourne Sexual Health Centre, Alfred Health, Melbourne, Australia
- Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Weiming Tang
- Institute of Global Health and Infectious Diseases, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Nora E. Rosenberg
- Department of Health Behavior, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Titi Gbajabiamila
- Clinical Sciences Department, Nigerian Institute of Medical Research, Lagos, Nigeria
- Department of Behavioral Science & Health Education, College for Public Health and Social Justice, Saint Louis University, St. Louis, Missouri, United States of America
| | - Susan Nkengasong
- Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Chisom Obiezu-Umeh
- Department of Behavioral Science & Health Education, College for Public Health and Social Justice, Saint Louis University, St. Louis, Missouri, United States of America
| | - David Oladele
- Clinical Sciences Department, Nigerian Institute of Medical Research, Lagos, Nigeria
- Department of Behavioral Science & Health Education, College for Public Health and Social Justice, Saint Louis University, St. Louis, Missouri, United States of America
| | - Juliet Iwelunmor
- Department of Behavioral Science & Health Education, College for Public Health and Social Justice, Saint Louis University, St. Louis, Missouri, United States of America
| | - Oliver Ezechi
- Clinical Sciences Department, Nigerian Institute of Medical Research, Lagos, Nigeria
| | - Joseph D. Tucker
- Department of Medicine, Division of Infectious Diseases, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
- Institute of Global Health and Infectious Diseases, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
- Clinical Research Department, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom
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Al-Abdullatif AM, Al-Dokhny AA, Drwish AM. Implementing the Bashayer chatbot in Saudi higher education: measuring the influence on students' motivation and learning strategies. Front Psychol 2023; 14:1129070. [PMID: 37255522 PMCID: PMC10226531 DOI: 10.3389/fpsyg.2023.1129070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Accepted: 04/07/2023] [Indexed: 06/01/2023] Open
Abstract
Since the fourth industrial revolution, intelligent software and applications that attempt to mimic human behavior have become increasingly common. The chatbot is an example of an artificial intelligence-based computer program that simulates human behavior by having a conversation and interacting with users using natural language. The implementation of chatbot technology in the educational context is still in its nascent stage, and further investigation into measuring its effectiveness in supporting learning and teaching processes is required, particularly in the context of higher education. Thus, this study presents the design and implementation of a task-oriented chatbot, that is embedded into the WhatsApp application, called Bashayer. It aims at supporting postgraduate students' motivation and learning strategies in Saudi Arabia. A quasi-experimental design with a single-subject experimental approach was adopted with a sample of 60 Saudi postgraduate students. The descriptive analysis of the collected data showed promising results of postgraduate students utilized the Bashayer chatbot system. Participants in the experimental group that used Bashayer were more motivated to learn than those in the control group. Participants also practiced more cognitive and metacognitive learning strategies while utilizing the chatbot compared to the control group. The results of this study are encouraging for the development of chatbot systems similar to Bashayer to support postgraduate students' successful learning. These results contribute to bridging the research gap and adding to the literature on chatbots use in postgraduate educational contexts.
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Affiliation(s)
| | - Amany Ahmed Al-Dokhny
- Educational Technology Department, College of Specific Education, Ain Shams University, Cairo, Egypt
| | - Amr Mohammed Drwish
- Educational Technology Department, College of Education, Helwan University, Cairo, Egypt
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Preiksaitis C, Dayton JR, Kabeer R, Bunney G, Boukhman M. Teaching Principles of Medical Innovation and Entrepreneurship Through Hackathons: Case Study and Qualitative Analysis. JMIR MEDICAL EDUCATION 2023; 9:e43916. [PMID: 36826988 PMCID: PMC10007000 DOI: 10.2196/43916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Revised: 02/06/2023] [Accepted: 02/13/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Innovation and entrepreneurship training are increasingly recognized as being important in medical education. However, the lack of faculty comfort with the instruction of these concepts as well as limited scholarly recognition for this work has limited the implementation of curricula focused on these skills. Furthermore, this lack of familiarity limits the inclusion of practicing physicians in health care innovation, where their experience is valuable. Hackathons are intense innovation competitions that use gamification principles to increase comfort with creative thinking, problem-solving, and interpersonal collaboration, but they require further exploration in medical innovation. OBJECTIVE To address this, we aimed to design, implement, and evaluate a health care hackathon with 2 main goals: to improve emergency physician familiarity with the principles of health care innovation and entrepreneurship and to develop innovative solutions to 3 discrete problems facing emergency medicine physicians and patients. METHODS We used previously described practices for conducting hackathons to develop and implement our hackathon (HackED!). We partnered with the American College of Emergency Physicians, the Stanford School of Biodesign, and the Institute of Design at Stanford (d.school) to lend institutional support and expertise in health care innovation to our event. We determined a location, time frame, and logistics for the competition and settled on 3 use cases for teams to work on. We planned to explore the learning experience of participants within a pragmatic paradigm and complete an abductive thematic analysis using data from a variety of sources. RESULTS HackED! took place from October 1-3, 2022. In all, 3 teams developed novel solutions to each of the use cases. Our investigation into the educational experience of participants suggested that the event was valuable and uncovered themes suggesting that the learning experience could be understood within a framework from entrepreneurship education not previously described in relation to hackathons. CONCLUSIONS Health care hackathons appear to be a viable method of increasing physician experience with innovation and entrepreneurship principles and addressing complex problems in health care. Hackathons should be considered as part of educational programs that focus on these concepts.
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Affiliation(s)
- Carl Preiksaitis
- Department of Emergency Medicine, Stanford University School of Medicine, Palo Alto, CA, United States
| | - John R Dayton
- Department of Emergency Medicine, Stanford University School of Medicine, Palo Alto, CA, United States
| | - Rana Kabeer
- Department of Emergency Medicine, Stanford University School of Medicine, Palo Alto, CA, United States
| | - Gabrielle Bunney
- Department of Emergency Medicine, Stanford University School of Medicine, Palo Alto, CA, United States
| | - Milana Boukhman
- Department of Emergency Medicine, Stanford University School of Medicine, Palo Alto, CA, United States
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Staziaki PV, Santinha JAA, Coelho MO, Angulo D, Hussain M, Folio LR. Gamification in Radiology Training Module Developed During the Society for Imaging Informatics in Medicine Annual Meeting Hackathon. J Digit Imaging 2022; 35:714-722. [PMID: 35166970 PMCID: PMC9156580 DOI: 10.1007/s10278-022-00603-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Revised: 01/31/2022] [Accepted: 02/02/2022] [Indexed: 12/15/2022] Open
Abstract
The purpose of this manuscript is to report our experience in the 2021 SIIM Virtual Hackathon, where we developed a proof-of-concept of a radiology training module with elements of gamification. In the 50 h allotted in the hackathon, we proposed an idea, connected with colleagues from five different countries, and completed an operational proof-of-concept, which was demonstrated live at the hackathon showcase, competing with eight other teams. Our prototype involved participants annotating publicly available chest radiographs of patients with tuberculosis. We showed how we could give experience points to trainees based on annotation precision compared to ground truth radiologists' annotation, ranked in a live leaderboard. We believe that gamification elements could provide an engaging solution for radiology education. Our project was awarded first place out of eight participating hackathon teams.
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Affiliation(s)
- Pedro V Staziaki
- Department of Radiology, Boston Medical Center, Boston University School of Medicine, 480 Harrison Ave, FGH Building, 4th floor, MA, 02118, Boston, USA.
- Division of Cardiovascular Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit St, Boston, MA, 02114, USA.
| | - João A A Santinha
- IST University of Lisbon, Av. Rovisco Pais 1, 1049-001, Lisbon, Portugal
- Clinical Computational Imaging Group, Champalimaud Foundation, Av. Brasília, 1400-038, Lisbon, Portugal
| | - Marcelo O Coelho
- Department of Imaging Diagnosis, Federal University of São Paulo (UNIFESP), Rua Napoleão de Barros, 800, Vila Clementino, São Paulo, SP, CEP 04024-002, Brazil
| | - Diego Angulo
- Prodigious, CLL 93B N 13 44 PISO 3, Bogotá, Colombia
| | - Mohannad Hussain
- Techie Maestro Inc., 928 Creekside Drive, Waterloo, ON, N2V2W6, Canada
| | - Les R Folio
- NIH Clinical Center, 10 Center Drive, Bethesda, MD, 20892, USA
- Adjunct Clinical Professor of Radiology, George Washington University Hospital, Washington, DC, USA
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Terlouw G, Kuipers D, Veldmeijer L, van 't Veer J, Prins J, Pierie JP. Boundary Objects as Dialogical Learning Accelerators for Social Change in Design for Health: Systematic Review. JMIR Hum Factors 2022; 9:e31167. [PMID: 35113023 PMCID: PMC8855288 DOI: 10.2196/31167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Revised: 10/15/2021] [Accepted: 10/17/2021] [Indexed: 11/28/2022] Open
Abstract
Background Boundary objects can add value for innovative design and implementation research in health care through their organizational focus and the dynamic structure between ill-structured and tailored use. However, when innovation is approached as a boundary object, more attention will need to be paid to the preimplementation phase. Research and design thinking pay attention to the preimplementation stage but do not have a social or organizational focus per se. The integration of boundary objects in design methodologies can provide a more social and organizational focus in innovative design projects by mapping out the mechanisms that occur at boundaries during design. Four dialogical learning mechanisms that can be triggered at boundaries have been described in the literature: identification, coordination, reflection, and transformation. These mechanisms seem suitable for integration in innovative design research on health. Objective Focusing on innovation in health, this study aims to find out whether the different learning mechanisms can be linked to studies on health innovation that mention boundary objects as a concept and assess whether the related mechanisms provide insight into the stage of the design and implementation or change process. Methods The following 6 databases were searched for relevant abstracts: PubMed, Scopus, Education Resources Information Center, PsycINFO, Information Science and Technology Abstracts, and Embase. These databases cover a wide range of published studies in the field of health. Results Our initial search yielded 3102 records; after removing the duplicates, 2186 (70.47%) records were screened on the title and abstract, and 25 (0.81%) papers were included; of the 13 papers where we identified 1 mechanism, 5 (38%) described an innovation or innovative project, and of the 12 papers where we identified more mechanisms, 9 (75%) described the development or implementation of an innovation. The reflective mechanism was not identified solely but was present in papers describing a more successful development or implementation project of innovation. In these papers, the predetermined goals were achieved, and the process of integration was relatively smoother. Conclusions The concept of boundary objects has found its way into health care. Although the idea of a boundary object was introduced to describe how specific artifacts can fulfill a bridging function between different sociocultural sites and thus have a social focus, the focus in the included papers was often on the boundary object itself rather than the social effect. The reflection and transformation mechanisms were underrepresented in the included studies but based on the findings in this review, pursuing to trigger the reflective mechanism in design, development, and implementation projects can lead to a more fluid and smooth integration of innovation into practice.
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Affiliation(s)
- Gijs Terlouw
- NHL Stenden University of Applied Sciences, Leeuwarden, Netherlands.,Medical Faculty Lifelong Learning, Education & Assessment Research Network, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Derek Kuipers
- Research Group Serious Gaming, NHL Stenden University of Applied Sciences, Leeuwarden, Netherlands
| | - Lars Veldmeijer
- NHL Stenden University of Applied Sciences, Leeuwarden, Netherlands
| | - Job van 't Veer
- Research Group Digital Innovation in Healthcare and Social Work, NHL Stenden University of Applied Sciences, Leeuwarden, Netherlands
| | - Jelle Prins
- University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Jean-Pierre Pierie
- Post Graduate School of Medicine, University Medical Center Groningen, University of Groningen, Groningen, Netherlands.,Department of Surgery, Medical Center Leeuwarden, Leeuwarden, Netherlands
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10
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From spreading to embedding innovation in health care: Implications for theory and practice. Health Care Manage Rev 2021; 47:236-244. [PMID: 34319279 PMCID: PMC9162066 DOI: 10.1097/hmr.0000000000000323] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
In broad terms, current thinking and literature on the spread of innovations in health care presents it as the study of two unconnected processes—diffusion across adopting organizations and implementation within adopting organizations. Evidence from the health care environment and beyond, however, shows the significance and systemic nature of postadoption challenges in sustainably implementing innovations at scale. There is often only partial diffusion of innovative practices, initial adoption that is followed by abandonment, incomplete or tokenistic implementation, and localized innovation modifications that do not provide feedback to inform global innovation designs.
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Petruzelkova L, Jiranova P, Soupal J, Kozak M, Plachy L, Neuman V, Pruhova S, Obermannova B, Kolouskova S, Sumnik Z. Pre-school and school-aged children benefit from the switch from a sensor-augmented pump to an AndroidAPS hybrid closed loop: A retrospective analysis. Pediatr Diabetes 2021; 22:594-604. [PMID: 33576551 DOI: 10.1111/pedi.13190] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Revised: 11/18/2020] [Accepted: 01/29/2021] [Indexed: 01/10/2023] Open
Abstract
OBJECTIVE Data on closed loop systems in young children with type 1 diabetes (T1D) are limited. We tested the efficacy and safety of an open-source, do-it-yourself automated insulin delivery system AndroidAPS in preschool and school-aged children. RESEARCH DESIGN AND METHODS This retrospective study analyzed diabetes control in 18 preschool (3-7 years) and 18 school-aged children (8-14 years) with T1D who switched from a sensor-augmented pump (SAP) to AndroidAPS. We compared the CGM parameters and HbA1c levels 3 months before and 6 months after the initiation of AndroidAPS therapy and evaluated frequency of severe adverse events during AndroidAPS use, the most frequent reasons for its interruption, and the experience and psychosocial benefits of AndroidAPS use. RESULTS General glycemic control was significantly improved after the switch from SAP to AndroidAPS. Time in range (TIR) increased in both preschool (70.8%-78.6%, p = 0.004) and school-aged children (77.2%-82.9%, p < 0.001), whereas HbA1c levels decreased (preschool children 53.8-48.5 mmol/mol, p < 0.001; school-aged children 52.6-45.1 mmol/mol, p = 0.001). Time spent in range of 3.0-3.8 mmol/L increased slightly in school children (2.6%-3.8%, p = 0.040), but not in preschool children (3.0%-3.0%, p = 0.913). Time spent at <3 mmol/L remained unchanged in both preschool (0.95%-0.67%, p = 0.432) and school-aged children (0.8%-0.8%, p = 1.000). No episodes of severe hypoglycemia or DKA and significant improvement of quality of life were reported by AndroidAPS users. CONCLUSIONS AndroidAPS seems effective for T1D control both in preschool and school-age children but further validation by prospective studies is necessary.
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Affiliation(s)
- Lenka Petruzelkova
- Department of Pediatrics, Motol University Hospital and 2nd Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Pavlina Jiranova
- Department of Pediatrics, Motol University Hospital and 2nd Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Jan Soupal
- 3rd Department of Internal Medicine, 1st Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Milos Kozak
- IT division, CLOSED LOOP Systems, Prague, Czech Republic
| | - Lukas Plachy
- Department of Pediatrics, Motol University Hospital and 2nd Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Vit Neuman
- Department of Pediatrics, Motol University Hospital and 2nd Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Stepanka Pruhova
- Department of Pediatrics, Motol University Hospital and 2nd Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Barbora Obermannova
- Department of Pediatrics, Motol University Hospital and 2nd Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Stanislava Kolouskova
- Department of Pediatrics, Motol University Hospital and 2nd Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Zdenek Sumnik
- Department of Pediatrics, Motol University Hospital and 2nd Faculty of Medicine, Charles University, Prague, Czech Republic
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Ramadi KB, Nguyen FT. Rapid crowdsourced innovation for COVID-19 response and economic growth. NPJ Digit Med 2021; 4:18. [PMID: 33564061 PMCID: PMC7873189 DOI: 10.1038/s41746-021-00397-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2020] [Accepted: 12/09/2020] [Indexed: 11/18/2022] Open
Abstract
The COVID-19 pandemic has profoundly affected life worldwide. Governments have been faced with the formidable task of implementing public health measures, such as social distancing, quarantines, and lockdowns, while simultaneously supporting a sluggish economy and stimulating research and development (R&D) for the pandemic. Catalyzing bottom-up entrepreneurship is one method to achieve this. Home-grown efforts by citizens wishing to contribute their time and resources to help have sprouted organically, with ideas shared widely on the internet. We outline a framework for structured, crowdsourced innovation that facilitates collaboration to tackle real, contextualized problems. This is exemplified by a series of virtual hackathon events attracting over 9000 applicants from 142 countries and 49 states. A hackathon is an event that convenes diverse individuals to crowdsource solutions around a core set of predetermined challenges in a limited amount of time. A consortium of over 100 partners from across the healthcare spectrum and beyond defined challenges and supported teams after the event, resulting in the continuation of at least 25% of all teams post-event. Grassroots entrepreneurship can stimulate economic growth while contributing to broader R&D efforts to confront public health emergencies.
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Affiliation(s)
- Khalil B Ramadi
- Hacking Medicine, Massachusetts Institute of Technology, Cambridge, MA, USA. .,School of Engineering, Massachusetts Institute of Technology, Cambridge, MA, USA. .,Harvard TH Chan School of Public Health, Harvard University, Boston, MA, USA. .,Division of Engineering, New York University Abu Dhabi, Abu Dhabi, UAE. .,Tandon School of Engineering, New York University, New York, NY, USA.
| | - Freddy T Nguyen
- Hacking Medicine, Massachusetts Institute of Technology, Cambridge, MA, USA. .,Innovation Initiative, Massachusetts Institute of Technology, Cambridge, MA, USA. .,Institute for Medical Engineering and Sciences, Massachusetts Institute of Technology, Cambridge, MA, USA. .,Icahn School of Medicine, Mt Sinai Hospital, New York, NY, USA.
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13
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Braune K, Rojas PD, Hofferbert J, Valera Sosa A, Lebedev A, Balzer F, Thun S, Lieber S, Kirchberger V, Poncette AS. Interdisciplinary Online Hackathons as an Approach to Combat the COVID-19 Pandemic: Case Study. J Med Internet Res 2021; 23:e25283. [PMID: 33497350 PMCID: PMC7872325 DOI: 10.2196/25283] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 01/02/2021] [Accepted: 01/16/2021] [Indexed: 12/24/2022] Open
Abstract
Background The COVID-19 outbreak has affected the lives of millions of people by causing a dramatic impact on many health care systems and the global economy. This devastating pandemic has brought together communities across the globe to work on this issue in an unprecedented manner. Objective This case study describes the steps and methods employed in the conduction of a remote online health hackathon centered on challenges posed by the COVID-19 pandemic. It aims to deliver a clear implementation road map for other organizations to follow. Methods This 4-day hackathon was conducted in April 2020, based on six COVID-19–related challenges defined by frontline clinicians and researchers from various disciplines. An online survey was structured to assess: (1) individual experience satisfaction, (2) level of interprofessional skills exchange, (3) maturity of the projects realized, and (4) overall quality of the event. At the end of the event, participants were invited to take part in an online survey with 17 (+5 optional) items, including multiple-choice and open-ended questions that assessed their experience regarding the remote nature of the event and their individual project, interprofessional skills exchange, and their confidence in working on a digital health project before and after the hackathon. Mentors, who guided the participants through the event, also provided feedback to the organizers through an online survey. Results A total of 48 participants and 52 mentors based in 8 different countries participated and developed 14 projects. A total of 75 mentorship video sessions were held. Participants reported increased confidence in starting a digital health venture or a research project after successfully participating in the hackathon, and stated that they were likely to continue working on their projects. Of the participants who provided feedback, 60% (n=18) would not have started their project without this particular hackathon and indicated that the hackathon encouraged and enabled them to progress faster, for example, by building interdisciplinary teams, gaining new insights and feedback provided by their mentors, and creating a functional prototype. Conclusions This study provides insights into how online hackathons can contribute to solving the challenges and effects of a pandemic in several regions of the world. The online format fosters team diversity, increases cross-regional collaboration, and can be executed much faster and at lower costs compared to in-person events. Results on preparation, organization, and evaluation of this online hackathon are useful for other institutions and initiatives that are willing to introduce similar event formats in the fight against COVID-19.
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Affiliation(s)
- Katarina Braune
- Department of Paediatric Endocrinology and Diabetes, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.,Hacking Health Berlin, Berlin, Germany.,Berlin Institute of Health, Berlin, Germany
| | | | | | - Alvaro Valera Sosa
- Hacking Health Berlin, Berlin, Germany.,CityLAB Berlin, Building Health Lab, Berlin, Germany.,Department of Design and Typologies, Technische Universität Berlin, Berlin, Germany
| | | | - Felix Balzer
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Anesthesiology and Intensive Care Medicine, Berlin, Germany.,Einstein Center Digital Future, Berlin, Germany
| | | | - Sascha Lieber
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Anesthesiology and Intensive Care Medicine, Berlin, Germany.,Executive Board, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Valerie Kirchberger
- Executive Board, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Akira-Sebastian Poncette
- Hacking Health Berlin, Berlin, Germany.,Berlin Institute of Health, Berlin, Germany.,Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Anesthesiology and Intensive Care Medicine, Berlin, Germany.,Einstein Center Digital Future, Berlin, Germany
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14
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Rauen K, Vetter S, Eisele A, Biskup E, Delsignore A, Rufer M, Weidt S. Internet Cognitive Behavioral Therapy With or Without Face-to-Face Psychotherapy: A 12-Weeks Clinical Trial of Patients With Depression. Front Digit Health 2020; 2:4. [PMID: 34713017 PMCID: PMC8521970 DOI: 10.3389/fdgth.2020.00004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Accepted: 04/30/2020] [Indexed: 12/15/2022] Open
Abstract
Depressive disorders are a curable, global health problem. However, most patients remain untreated, and more and more patients use internet-based interventions, but it is unclear whether it is beneficial for ongoing face-to-face psychotherapy. Thus, we compared the outcome of internet cognitive behavioral therapy (ICBT) with (ICBT+) or without (ICBT) additional face-to-face outpatient psychotherapy in adult patients with moderate to severe depressive disorder. For this longitudinal interventional clinical trial (NCT02112266), 168 of 252 online recruited adults with depressive symptoms received ICBT+ (n = 96) or ICBT (n = 72). Demographics (sex, age, age at first depressive episode, years of education, duration of depressive symptoms) were assessed and compared between groups. All patients underwent ICBT for 12 weeks. Quality of life (QoL) and severity of depressive symptoms were assessed within each group at three time points [baseline (T0), postinterventional after ICBT at 12 weeks (T1), and for follow-up at 6 months (T2)] using the World Health Organization Quality of Life Questionnaire (WHOQOL-BREF) global score to assess QoL as primary and the Beck Depression Inventory (BDI-II) to assess self-rated depressive symptoms as secondary outcome variables, respectively. Differences were assessed between groups using t test and over time using repeated-measures analysis of variance. Data of intention-to-treat analysis are given as mean ± SD. Group differences were assumed at p < 0.05. Partial η2 is given as effect size. Demographic data, QoL, and depressive symptoms did not differ between groups (ICBT+/ICBT) at baseline (T0). Patients of both groups suffered from moderate to severe depressive disorders and gained improved QoL scores (WHOQOL-BREF-global: p < 0.001, η2 = 0.16), as well as experienced decreased depressive symptoms (BDI-II: p < 0.001, η2 = 0.2) after 12 weeks of ICBT compared to baseline. Patients without additional face-to-face outpatient psychotherapy lost QoL-albeit not significant-and had increased depressive symptoms (BDI: p = 0.02, η2 = 0.04) at 6 months' follow-up. Thus, ICBT is suitable for psychiatric treatment, although additional face-to-face outpatient psychotherapy helps stabilizing long-term outcome.
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Affiliation(s)
- Katrin Rauen
- Department of Geriatric Psychiatry, Psychiatric Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Stefan Vetter
- Department of Psychiatry, Psychotherapy, and Psychosomatics, Psychiatric Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Amanda Eisele
- Department of Geriatric Psychiatry, Psychiatric Hospital Zurich, University of Zurich, Zurich, Switzerland.,Department of Neurology, University Hospital Zurich, Zurich, Switzerland
| | - Ewelina Biskup
- Department of Advanced Biomedical Sciences, Frederico II University of Naples, Naples, Italy.,College of Fundamental Medicine, Shanghai University of Medicine and Health Sciences, Shanghai, China
| | - Aba Delsignore
- Faculty of Medicine, University of Zurich, Zurich, Switzerland
| | - Michael Rufer
- Department of Psychiatry, Psychotherapy, and Psychosomatics, Psychiatric Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Steffi Weidt
- Department of Psychiatry, Psychotherapy, and Psychosomatics, Psychiatric Hospital Zurich, University of Zurich, Zurich, Switzerland
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15
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Poncette AS, Mosch L, Spies C, Schmieding M, Schiefenhövel F, Krampe H, Balzer F. Improvements in Patient Monitoring in the Intensive Care Unit: Survey Study. J Med Internet Res 2020; 22:e19091. [PMID: 32459655 PMCID: PMC7307326 DOI: 10.2196/19091] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Revised: 05/05/2020] [Accepted: 05/13/2020] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Due to demographic change and, more recently, coronavirus disease (COVID-19), the importance of modern intensive care units (ICU) is becoming apparent. One of the key components of an ICU is the continuous monitoring of patients' vital parameters. However, existing advances in informatics, signal processing, or engineering that could alleviate the burden on ICUs have not yet been applied. This could be due to the lack of user involvement in research and development. OBJECTIVE This study focused on the satisfaction of ICU staff with current patient monitoring and their suggestions for future improvements. We aimed to identify aspects of monitoring that interrupt patient care, display devices for remote monitoring, use cases for artificial intelligence (AI), and whether ICU staff members are willing to improve their digital literacy or contribute to the improvement of patient monitoring. We further aimed to identify differences in the responses of different professional groups. METHODS This survey study was performed with ICU staff from 4 ICUs of a German university hospital between November 2019 and January 2020. We developed a web-based 36-item survey questionnaire, by analyzing a preceding qualitative interview study with ICU staff, about the clinical requirements of future patient monitoring. Statistical analyses of questionnaire results included median values with their bootstrapped 95% confidence intervals, and chi-square tests to compare the distributions of item responses of the professional groups. RESULTS In total, 86 of the 270 ICU physicians and nurses completed the survey questionnaire. The majority stated they felt confident using the patient monitoring equipment, but that high rates of false-positive alarms and the many sensor cables interrupted patient care. Regarding future improvements, respondents asked for wireless sensors, a reduction in the number of false-positive alarms, and hospital standard operating procedures for alarm management. Responses to the display devices proposed for remote patient monitoring were divided. Most respondents indicated it would be useful for earlier alerting or when they were responsible for multiple wards. AI for ICUs would be useful for early detection of complications and an increased risk of mortality; in addition, the AI could propose guidelines for therapy and diagnostics. Transparency, interoperability, usability, and staff training were essential to promote the use of AI. The majority wanted to learn more about new technologies for the ICU and required more time for learning. Physicians had fewer reservations than nurses about AI-based intelligent alarm management and using mobile phones for remote monitoring. CONCLUSIONS This survey study of ICU staff revealed key improvements for patient monitoring in intensive care medicine. Hospital providers and medical device manufacturers should focus on reducing false alarms, implementing hospital alarm standard operating procedures, introducing wireless sensors, preparing for the use of AI, and enhancing the digital literacy of ICU staff. Our results may contribute to the user-centered transfer of digital technologies into practice to alleviate challenges in intensive care medicine. TRIAL REGISTRATION ClinicalTrials.gov NCT03514173; https://clinicaltrials.gov/ct2/show/NCT03514173.
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Affiliation(s)
- Akira-Sebastian Poncette
- Department of Anesthesiology and Intensive Care Medicine, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.,Einstein Center Digital Future, Berlin, Germany
| | - Lina Mosch
- Department of Anesthesiology and Intensive Care Medicine, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Claudia Spies
- Department of Anesthesiology and Intensive Care Medicine, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Malte Schmieding
- Department of Anesthesiology and Intensive Care Medicine, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.,Einstein Center Digital Future, Berlin, Germany
| | - Fridtjof Schiefenhövel
- Department of Anesthesiology and Intensive Care Medicine, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.,Einstein Center Digital Future, Berlin, Germany
| | - Henning Krampe
- Department of Anesthesiology and Intensive Care Medicine, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Felix Balzer
- Department of Anesthesiology and Intensive Care Medicine, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.,Einstein Center Digital Future, Berlin, Germany
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