Designing a comprehensive minimum dataset for patients with COVID-19 in Iranian hospital information systems

BACKGROUND

The Minimum Data Set (MDS) plays a vital role in data exchange, collection and quality improvement. In the context of the COVID-19 pandemic, there is a need for a tailored MDS that aligns with the specific information needs of the Iranian community and integrates seamlessly into the country's Hospital Information Systems (HIS).

OBJECTIVE

The study aimed to develop a comprehensive MDS for COVID-19 patients in Iran, with objectives to identify essential data elements and integrate the MDS into HIS, enhancing data exchange and supporting decision-making.

METHOD

This study employed a comparative-descriptive approach to design COVID-19 patient data elements based on World Health Organisation and Centers for Disease Control and Prevention guidelines. The Delphi technique involved 35 experts in two rounds for checklist refinement. The finalised MDS consisted of 9 main terms and 80 sub-terms, analysed using descriptive statistics and IBM SPSS software.

RESULTS

Of 35 experts involved with the study, 69% were male and 31% female, and Health Information Management experts were the majority (34%). The refined MDS for COVID-19 in Iran comprises 50 data elements, while 30 elements were excluded. The MDS includes 8 main terms and 80 sub-terms, with unanimous approval for identity, underlying disease, and treatment sections.

CONCLUSION

The customised MDS for COVID-19 patients in Iran addresses data collection challenges and supports effective disease prevention and management. By providing comprehensive and reliable information, the MDS enhances healthcare quality, facilitates timely access to medical records, and fosters integrated health services.

The Role of Electronic Health Tools in Unwanted Pregnancy Prevention, Abortion and Post-Abortion Follow-Up: A Systematic Review

Background

More than 30% of women experience at least one abortion. To date, there has been no comprehensive mobile health project on the impact of technology on access to abortion, contraception, and post-abortion follow-up. The purpose of this study was to review published studies on the role of electronic health in the prevention of unwanted pregnancy, abortion, and post-abortion follow-up.

Materials and Methods

The Web of Science, PubMed, ScienceDirect, and EMBASE databases were searched to find relevant articles published between 2008 and 2018. A systematic review study was conducted on 33 relevant articles. All studies related to the use and impact of electronic health on unwanted pregnancy prevention, abortion and post-abortion follow-up in English from January 2008 to December 2018 were included. The quality of the studies was evaluated using the PRISMA-S.

Results

Thirty-three studies met the inclusion criteria for the review. The Studies were divided into four main groups of women's experiences on the use of mobile health and telemedicine technologies for at-home medical abortion, unwanted pregnancy prevention, abortion, and post-abortion follow-up. The results showed the significant impact of using electronic health on unwanted pregnancy prevention, abortion, and post-abortion follow-up.

Conclusions

Health technologies have the potential to be used as a low-cost and accessible method to replace abortion services. They can facilitate remote care and quick access to information to complete the gaps in access to abortion. Therefore, it is necessary for health service providers to be aware of the possibility of the client's access to electronic health tools.

Smartphone-based application for self-management of patients with colorectal cancer: development and usability evaluation

PURPOSE

Self-management is considered essential for improving the treatment and management of colorectal cancer patients. This study was conducted to develop and evaluate the usability of a smartphone-based application for the self-management of patients with colorectal cancer.

METHODS

We developed an Android-based application called "Colorectal Cancer Along (ColorectAlong)" for the self-management of colorectal cancer. Seventeen patients, from the Cancer Institute of Iran, evaluated the usability of this application for 2 weeks using a standard questionnaire for user interaction satisfaction (QUIS) version 5.5. The obtained data was analyzed using SPSS software version 26.

RESULTS

The ColorectAlong application was developed with features covering several areas of colorectal cancer self-management. The areas available for evaluation in the app are patient profile; medication management; nutrition and diet management; pain management; mental health; smoking cessation and alcohol reduction; educational content; and adding reminders, questions, and notes. Our results indicate that the usability of this application is good with an average QUIS score of 8.03 out of 9.

CONCLUSION

The ColorectAlong application can improve self-management, assist patients, and facilitate access to required information without the need for internet access.

Thymoquinone Ameliorate Hepatorenal Toxicity Associated With Propylthiouracil-Induced Hypothyroidism in Juvenile Rats

BACKGROUND

An increasing number of studies suggest that hypothyroidism may lead to hepatorenal toxicity. This study examined whether thymoquinone (TQ), the main active Nigella sativa constituent, could prevent the detrimental influences of hepatorenal toxicity of hypothyroidism during the juvenile period in rats.

METHODS

The male rats were randomly divided into four groups (n = 7), including control, propylthiouracil (PTU), PTU-TQ 5 mg/kg, and PTU-TQ 10 mg/kg. PTU was dissolved in drinking water at a concentration of 0.05% and administered for six weeks. In the PTU-TQ5 and PTU-TQ10 groups, animals received PTU plus 5 mg/kg and 10 mg/kg of the TQ (i.p.) for six weeks, respectively. The rats were evaluated after TQ treatment by measuring serum markers of liver and kidney function tests as well as oxidative stress biomarkers in liver and kidney tissues.

RESULTS

Administration of TQ (5 and 10 mg/kg) decreased oxidative stress damage in liver and kidney tissue in hypothyroidism rats with improvement in activities of antioxidant enzymes and a decrease in MDA in both liver and kidney homogenates. Furthermore, TQ treatment significantly inhibited the elevation of serum biochemical markers of liver and kidney function associated with this hepatorenal toxicity.

CONCLUSION

These results suggest that the protective effect of TQ in hypothyroidism-induced hepatorenal toxicity in rats is attributed to its ability to reduce oxidative stress in hepatic and renal tissues. However, more studies are recommended to investigate the exact mechanism (s) for the effect of TQ on hepatorenal outcomes of hypothyroidism in human subjects.

Clinical Characteristics and Neonatal Outcomes of Pregnant Patients With COVID-19: A Systematic Review

Background and Objective: Coronavirus disease 2019 (COVID-19) characterized by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has created serious concerns about its potential adverse effects. There are limited data on clinical, radiological, and neonatal outcomes of pregnant women with COVID-19 pneumonia. This study aimed to assess clinical manifestations and neonatal outcomes of pregnant women with COVID-19.

Methods: We conducted a systematic article search of PubMed, EMBASE, Scopus, Google Scholar, and Web of Science for studies that discussed pregnant patients with confirmed COVID-19 between January 1, 2020, and April 20, 2020, with no restriction on language. Articles were independently evaluated by two expert authors. We included all retrospective studies that reported the clinical features and outcomes of pregnant patients with COVID-19.

Results: Forty-seven articles were assessed for eligibility; 13 articles met the inclusion criteria for the systematic review. Data is reported for 235 pregnant women with COVID-19. The age range of patients was 25–40 years, and the gestational age ranged from 8 to 40 weeks plus 6 days. Clinical characteristics were fever [138/235 (58.72%)], cough [111/235 (47.23%)], and sore throat [21/235 (8.93%)]. One hundred fifty six out of 235 (66.38%) pregnant women had cesarean section, and 79 (33.62%) had a vaginal delivery. All the patients showed lung abnormalities in CT scan images, and none of the patients died. Neutrophil cell count, C-reactive protein (CRP) concentration, ALT, and AST were increased but lymphocyte count and albumin levels were decreased. Amniotic fluid, neonatal throat swab, and breastmilk samples were taken to test for SARS-CoV-2 but all found negativ results. Recent published evidence showed the possibility of vertical transmission up to 30%, and neonatal death up to 2.5%. Pre-eclampsia, fetal distress, PROM, pre-mature delivery were the major complications of pregnant women with COVID-19.

Conclusions: Our study findings show that the clinical, laboratory and radiological characteristics of pregnant women with COVID-19 were similar to those of the general populations. The possibility of vertical transmission cannot be ignored but C-section should not be routinely recommended anymore according to latest evidences and, in any case, decisions should be taken after proper discussion with the family. Future studies are needed to confirm or refute these findings with a larger number of sample sizes and a long-term follow-up period.

The Impact of Mobile Health on Cancer Screening: A Systematic Review

Introduction:

Mobile health is an emerging technology around the world that can be effective in cancer screening. This study aimed to examine the effectiveness of mobile health applications on cancer screening.

Methods:

We conducted a systematic literature review of studies related to the use of mobile health applications in cancer screening. We also conducted a comprehensive search of articles on cancer screening related to the use of mobile health applications in journals published between January 1, 2008, and January 31, 2019, using 5 databases: IEEE, Scopus, Web of Science, Science Direct and PubMed.

Results:

A total of 23 articles met the inclusion criteria and were included in the present review. All studies have identified positive effects of applications on cancer screening and clinical health outcomes. Furthermore, more than half of mobile applications had multiple functions such as providing information, planning and education. Moreover, most of the studies, which examined the satisfaction of patients and quality improvement, showed healthcare application users have significantly higher satisfaction of living and it leads to improving quality.

Conclusion:

This study found that the use of mobile health applications has a positive impact on health-related behaviours and outcomes. Application users were more satisfied with applying mobile health applications to manage their health condition in comparison with users who received conventional care.

New and Emerging Mobile Technologies for Healthcare (mHealth): A Horizon Scanning Study

Introduction: The popularity of mobile phone applications (Apps) and wearable devices for medical and health purposes is on the rise, but not all the mobile health (mHealth) innovative solutions that hit the news every day will sustain and have an impact on the health of people. The aim of this news-based horizon scanning study was to explore and identify new and emerging mobile technologies that are likely to impact the future of health and medical care.Methods: We conducted a systematic search on top ranking technology websites, according to Alexa Ranking, to identify health-related mobile-based technologies. We followed the EuroScan guide for horizon scanning, which recommends four steps: identification, filtering, prioritization, evaluation and conclusion. Technologies of interest were mHealth technologies regardless of their maturity level. The impact of technologies was assessed and scored in four areas: user, technology, safety, and cost.Results: Five hundred news articles were identified through the electronic search. After screening, 106 mHealth innovative technologies were included in this study. We categorized the included technologies into three groups: mobile apps (n=37), smart-connected devices (n=19), and wearables (n=50). mHealth technologies were most frequently developed for preventive health services, mental health services and rehabilitation services. There was no remarkable difference between the technology groups in terms of safety and adverse effects, but the groups were significantly different in terms of the target population, technology, and cost.Conclusion: An increasing number of solutions based on mobile technology is being developed by both public and private sectors but a low proportion of them undergo proper scientific evaluations. Despite the commercial availability of many innovative mobile apps, wearables, and smart connected devices, few of them have been actually used in clinics, hospitals, and health centers. There is a clear need for changes in healthcare service models to unlock the full potential of these innovative technologies.