Myopia information on TikTok: analysis factors that impact video quality and audience engagement

BACKGROUND

TikTok is emerging as a vital platform for health information dissemination. Despite myopia being a global public health issue, the high-quality myopia information shared by health educators often fails to go viral. It is imperative to analyze the factors influencing video quality and popularity, especially from diverse perspectives of researchers, health educators, and audiences.

METHODS

TikTok myopia-related videos were retrieved using TikTok's default comprehensive search (DCS) and most liked search (MLS) strategies. Venn diagrams were employed to illustrate the relationships and commonalities between the two strategies across four sample sizes (top 200, 150, 100, and 50). Video metadata, including details such as creator information, production properties, upload time, video duration, and viewer engagement, were collected. Video quality was assessed using the DISCERN tool. Video content covering six aspects of myopia were evaluated. The impact of search strategies, video sample sizes, production properties, and myopia content on video quality and audience engagement was analyzed through single-factor or multi-factor analysis.

RESULTS

DCS and MLS retrieval strategies, as well as varying sample sizes, resulted in differences in audience engagement for myopia videos (P < 0.039), while The DISCERN quality scores remained comparable (P > 0.221). Videos published by healthcare professionals (HCPs) and non-profit organizations (NPOs) were associated with high-quality (P ≤ 0.014) but comparatively lower popularity (P < 0.033). Videos that reported contents of risk factors, management, and outcomes showed high popularity (P < 0.018), while longer video duration (> 60s) exhibited the opposite trend (P < 0.032). Content on myopia evaluation (P ≤ 0.001) and management (P ≤ 0.022) and video duration were positively correlated with higher DISCERN quality.

CONCLUSION

Videos created by HCPs and NPOs deserve greater attention. Rather than pursuing entertaining effects, professional educators should emphasize producing concise, and high-quality myopia content that readily resonates with the audience and has the potential to go viral on the platform.

Determinants of accounting information system effectiveness and moderating role of external consultants: Empirical research in the Ben Tre Province of Vietnam

The characteristics of accounting information systems (AISs) within organizations and the factors affecting their effectiveness are investigated in this study. In particular, how external consultants moderate the relationship between the determinants and AIS effectiveness is examined. A total of 167 agricultural companies in the Ben Tre Province of Vietnam were surveyed using a regression-based partial least squares structural equation model. Then, the influence of these determinants on AIS effectiveness was evaluated. The findings showed that managers' involvement and managers' accounting knowledge positively affect AIS effectiveness. Furthermore, the involvement and knowledge of managers are mitigated by external consultants, which reduces the negative influence of such involvement on AIS effectiveness. This study aims to contribute to the body of knowledge on the determinants affecting AIS effectiveness by providing agricultural companies in Ben Tre and Vietnam with insights into the effectiveness of their respective AIS activities.

The unique identifier as one of the essential tools for steering universal health coverage: The case of Morocco

INTRODUCTION

Morocco is carrying out several actions to generalize basic compulsory health insurance (CHI). Managing this project requires coordination, information sharing, and the commitment of all actors to the goal of covering an additional 22 million people. One of the key factors for achieving this objective is the implementation of a unified registration system.

PURPOSE OF THE RESEARCH

The aim is to analyze the existing situation and the feasibility of implementing a unified registration system, and to describe the potential positive impact of the latter on the extension of CHI.

RESULTS

This work is based on a diagnosis of the current situation. It draws on the legal framework, all available documents and figures, and on an analytical reading supported by existing literature. It reveals that due to the inadequacy or even the absence of an appropriate legal basis, each managing body has its own registration system. The lack of a unified system has given rise to a number of constraints. These concern, among other things: (i) mobility between or within schemes, which does not operate smoothly because it leads to re-registration (ii) inadequate monitoring of double benefit claims, which is the case for more than one scheme, due to insufficient and hesitant anti-fraud action (iii) the sharing and use of reliable data, which hinders decision making, evaluation, and monitoring.

CONCLUSIONS

It is essential to adopt legal texts that will provide the basis for a unified system with regulations enabling the participation of all stakeholders, with the aim of steering the roll-out of CHI effectively and efficiently.

The internet and various social media platforms as source of information to patients with wounds in Kenya

Background

The internet has led to the realization that the world is a global village. Due to technological advancements, anyone can access the internet and various video sharing platforms and in turn, get access to or share information across the world. One of the most sought-after critical pieces of information on the internet, as well as social media platforms, is information regarding wounds.

Objective

To determine the views of patients with chronic wounds regarding the internet and other social media platforms as a source of information regarding wounds.

Methodology

A descriptive prospective study covering the period between November 1, 2022, and January 30, 2023. All patients with chronic wounds presenting in the plastic outpatient clinic, together with patients presenting themselves in the wound clinic at Kenyatta National Hospital (KNH) during this period, were informed about the study and asked to participate. After consenting, they were then required to sign an informed consent form after agreeing to participate. Data collection was done through interviews and filled out in structured questionnaires. Data points included demographics, information on internet use, and interaction with the various social media platforms.

Results

83.4% of the participants were of the opinion that the contents shared were done so by professionals, compared to 12.5% who indicated that the owners or uploaders of the contents were laymen. 2.6% and 1.5%, on the other hand, opined that the owners or uploaders of the contents were unknown and difficult to tell, respectively.

Discussion

The participants in the current study felt that some aspects regarding content on wounds that is shared on the internet as well as other social media platforms would need further improvement. Such areas included information regarding wound dressing concepts, the etiology and pathophysiology of wounds, complications of wounds, and wound pain management.

Quality of information about urologic pathology in English and Spanish from ChatGPT, BARD, and Copilot

INTRODUCTION AND OBJECTIVE

Generative artificial intelligence makes it possible to ask about medical pathologies in dialog boxes. Our objective was to analyze the quality of information about the most common urological pathologies provided by ChatGPT (OpenIA), BARD (Google), and Copilot (Microsoft).

METHODS

We analyzed information on the following pathologies and their treatments as provided by AI: prostate cancer, kidney cancer, bladder cancer, urinary lithiasis, and benign prostatic hypertrophy (BPH). Questions in English and Spanish were posed in dialog boxes; the answers were collected and analyzed with DISCERN questionnaires and the overall appropriateness of the response. Surgical procedures were performed with an informed consent questionnaire.

RESULTS

The responses from the three chatbots explained the pathology, detailed risk factors, and described treatments. The difference is that BARD and Copilot provide external information citations, which ChatGPT does not. The highest DISCERN scores, in absolute numbers, were obtained in Copilot; however, on the appropriacy scale it was noted that their responses were not the most appropriate. The best surgical treatment scores were obtained by BARD, followed by ChatGPT, and finally Copilot.

CONCLUSIONS

The answers obtained from generative AI on urological diseases depended on the formulation of the question. The information provided had significant biases, depending on pathology, language, and above all, the dialog box consulted.

#Fail: the quality and accuracy of nutrition-related information by influential Australian Instagram accounts

BACKGROUND

Social media is a popular source of information about food and nutrition. There is a high degree of inaccurate and poor-quality nutrition-related information present online. The aim of this study was to evaluate the quality and accuracy of nutrition-related information posted by popular Australian Instagram accounts and examine trends in quality and accuracy based on author, topic, post engagement, account verification and number of followers.

METHODS

A sample of posts by Australian Instagram accounts with ≥ 100,000 followers who primarily posted about nutrition was collected between September 2020 and September 2021. Posts containing nutrition-related information were evaluated to determine the quality and accuracy of the information. Quality was assessed using the Principles for Health-Related Information on Social Media tool and accuracy was assessed against information contained in the Australian Dietary Guidelines, Practice-based Evidence in Nutrition database, Nutrient Reference Values and Metafact.

RESULTS

A total of 676 posts were evaluated for quality and 510 posts for accuracy, originating from 47 Instagram accounts. Overall, 34.8% of posts were classified as being of poor quality, 59.2% mediocre, 6.1% good and no posts were of excellent quality. A total of 44.7% of posts contained inaccuracies. Posts authored by nutritionists or dietitians were associated with higher quality scores (β, 17.8, CI 13.94-21.65; P < 0.001) and higher accuracy scores (OR 4.69, CI 1.81-12.14, P = 0.001) compared to brands and other accounts. Information about supplements was of lower accuracy (OR 0.23, CI 0.10-0.51, P < 0.001) compared to information about weight loss and other nutrition topics. Engagement tended to be higher for posts of lower quality (β -0.59, P = 0.012), as did engagement rate (β -0.57, P = 0.016). There was no relationship between followers or account verification and information quality or accuracy and no relationship between engagement and accuracy.

CONCLUSIONS

Nutrition-related information published by influential Australian Instagram accounts is often inaccurate and of suboptimal quality. Information about supplements and posts by brand accounts is of the lowest quality and accuracy and information posted by nutritionists and dietitians is of a higher standard. Instagram users are at risk of being misinformed when engaging with Australian Instagram content for information about nutrition.

[Utilization of video consultation in cardiovascular lipid treatment]

BACKGROUND

Video consultation is a possibility for physician-patient communication independent of the location; however, only limited information is available for the possibility of sole use since 2018.

METHODS

After the implementation of video consultation (Viomedi) in lipid consultations at the Medical University Mainz, the patients in the first quarter of 2022 were assessed depending on the possibility, suitability and readiness to participate. Included were patients under lipid management and long COVID patients. After treatment an online survey was carried out on the utilization and appraisal.

RESULTS

Of the 134 patients 29.1% were inclusively treated (3 refusals). All subjects (16 replies) reported having managed (very) well. Advantages were seen in counselling and follow-up. Problems were feared with respect to technology and possible disorders. Data protection aspects played a subordinate role. In comparison to telephone calls, a significant improvement in the physician-patient relationship (p-value = 0.00027), the quality of treatment and information (p-value both = 0.00044), the access to care (p-value = 0.0053) and the communication (p-value = 0.021) was assumed. An improvement in access to care (p-value = 0.021) and the quality of information (p-value = 0.034) was seen in comparison to personal contact. The main problems were a lack of experience, technical requirements, technical problems and unpunctuality of the practitioner. The flexibility, low effort and the pleasant consultation were all praised. All subjects wanted to use the video consultation again.

CONCLUSION

Video consultation can represent a supplement to treatment of patients under lipid management. The correct use requires exact planning and further research.

[Contraception on YouTube, Instagram, and TikTok : A content and quality analysis]

BACKGROUND

Young people and adults increasingly obtain information about contraception via social media.

RESEARCH AIM

Against this background, the aim of this study is to investigate for the first time the content and quality of German-language contraceptive posts on YouTube, Instagram, and TikTok. Research questions on providers (F1), content (F2), and quality of contraceptive posts (F3) as well as audience reactions (F4) will be answered.

MATERIALS AND METHODS

A sample of N = 1000 contraceptive posts from YouTube (500), Instagram (250), and TikTok (250) was drawn. A maximum of 20 contraception-related audience comments per post were included in the comment sample (N = 12,454). Posts and comments were analyzed using reliability-tested codebooks. SPSS was used for data analysis. The study is preregistered and all data, materials, and analysis scripts are publicly available.

RESULTS

The majority of contraceptive posts were found to be from health laypersons (52%), followed by media professionals and health professionals (F1). In terms of content, contraceptive posts covered all available contraceptive methods, with the pill (69%) and condoms (40%) dominating (F2). According to common quality criteria, there were clear deficits, with YouTube videos scoring best in comparison (F3). TikTok videos, on the other hand, were top performers in terms of audience interaction, attracting the most views, likes, and comments. Comment columns were often used by the audience to share their own contraceptive experiences or ask follow-up questions (F4).

DISCUSSION

Future research as well as practice interventions are needed to further assess the quality of contraceptive information in social media and improve it in a more targeted way.

An empirical investigation on actual usage of educational app: Based on quality dimensions and mobile self-efficacy

The intention of this research is to analyze the actual use of educational app by Chinese students for learning purpose. Based on DeLone & McLean (D&M) this study proposes and tests a research model which analyzes the actual use of educational apps using data collected from the 357 Chinese students. Structural equation modeling (SEM) was applied to examine the hypothesis. Findings specify that information quality, system quality, service quality, mobile self-efficacy, and personal innovativeness is considerably associated to intentions to use educational app which eventually influences actual usage of educational apps. Additionally, trust in educational apps strengthens the connection between intentions to use educational apps and actual use of educational apps by students for learning purposes. However, the perceived risk indicated an insignificant association between intention to use educational apps and actual use of educational apps. This study contributes to DeLone & McLean (D&M) model by examing the moderating role of perceived risk, trust in an educational app.

Quality and accuracy of online nutrition-related information: a systematic review of content analysis studies

OBJECTIVE

This systematic review aimed to summarise the level of quality and accuracy of nutrition-related information on websites and social media and determine if quality and accuracy varied between websites and social media or publishers of information.

DESIGN

This systematic review was registered with PROSPERO (CRD42021224277). CINAHL, MEDLINE, Embase, Global Health and Academic Search Complete were systematically searched on 15 January 2021 to identify content analysis studies, published in English after 1989, that evaluated the quality and/or accuracy of nutrition-related information published on websites or social media. A coding framework was used to classify studies' findings about information quality and/or accuracy as poor, good, moderate or varied. The Academy of Nutrition and Dietetics Quality Criteria Checklist was used to assess the risk of bias.

SETTING

N/A.

PARTICIPANTS

N/A.

RESULTS

From 10 482 articles retrieved, sixty-four were included. Most studies evaluated information from websites (n 53, 82·8 %). Similar numbers of studies assessed quality (n 41, 64·1 %) and accuracy (n 47, 73·4 %). Almost half of the studies reported that quality (n 20, 48·8 %) or accuracy (n 23, 48·9 %) was low. Quality and accuracy of information were similar on social media and websites, however, varied between information publishers. High risk of bias in sample selection and quality or accuracy evaluations was a common limitation.

CONCLUSION

Online nutrition-related information is often inaccurate and of low quality. Consumers seeking information online are at risk of being misinformed. More action is needed to improve the public's eHealth and media literacy and the reliability of online nutrition-related information.

A Contemporary Review of Smart Phone Applications in Bariatric and Metabolic Surgery: an Underdeveloped Support Service

This study aims to be a contemporary review of mHealth apps in bariatric and metabolic surgery (BMS) to assess their quality using the Silberg scale as well as features, themes, usability, and medical/allied health professional involvement (MAPI). Apps were identified using search terms in the Android and Apple app stores. 52 apps were included. 42 (80.7%) apps main target users were patients. More than half, 27 (52%), targeted US based users. 29 (56%) had payment-restricted content. 42 (81%) had MAPI and the mean Silberg score was 5.2. Compared to previous studies the quality of BMS apps is improving with more MAPI and useful functionality. Wider use of mHealth apps for patient centred follow-up, management and care are yet to be widely implemented and explored.

Acceptance of e-learning in higher education: The role of task-technology fit with the information systems success model

The COVID-19 global epidemic has compelled higher education institutions to reconsider their teaching methods. Because of this public health emergency, universities in higher education have adopted e-learning techniques as a solution to face-to-face education. Thus, e-learning has emerged as a critical technology in education at higher education institutions. Nonetheless, the effectiveness of e-learning systems is largely dependent on students' adoption of such systems. The study aims to evaluate the usefulness of task-technology fit (TTF) with the information system success model (ISSM) in perceiving students' adoption of e-learning with the goal of encouraging them to adopt e-learning in the context of higher education. The study employed a quantitative approach, and a theoretical model was evaluated with proposed hypotheses to find the relationships between the constructs. A questionnaire based on TTF and ISSM was distributed among the students, and 260 valid responses were received using a sample random sampling technique. Data was analyzed with the help of SPSS and Partial Least Squares-Structural Equation Modeling (PLS-SEM). After analyzing the data, it was found that perceived ease of use, perceived usefulness, system use, and task technology fit of e-learning are positively and significantly influenced by system quality, information quality, perceived enjoyment, technology characteristics, and task characteristics. The results of TTF and ISSM on system use show a positive effect on e-learning benefits in educational institutions, with all male and female students completely satisfied with the use of e-learning systems. As a result, we advise students to use e-learning systems for educational purposes and should have motivated them to do so through lecturers at higher-level educational institutions.

Adoption of E-learning systems: An integration of ISSM and constructivism theories in higher education

Based on constructivism theory and the Information System Success Model, this study suggests a research model that examines the factors that influence students' collaborative engagement and satisfaction in an e-learning system setting. This study intends to validate the theoretical concepts and the Information System Success Model (ISSM) on e-learning platforms for user satisfaction and collaborative activity in order to expand the adoption of e-learning systems in higher education. This research used a questionnaire as the primary data collection method to obtain information for the study from 300 responses from different students at the University of Bisha, who all use e-learning platforms. The results were achieved using structural equation modeling, a quantitative research technique (SEM-AMOS). All of the study's hypotheses were supported, according to the findings of the structural model and hypothesis testing. The outcomes of peer interaction (IP) and instructor interaction (IL) have a favorable impact on satisfaction and teamwork, which have a beneficial impact on the usage of e-learning in higher education. This is advantageous for sustainability as well as the adoption of e-learning systems. Finally, the study demonstrates that user happiness and collaborative involvement have a favorable impact on the utilization of e-learning systems. As a result, universities should promote e-learning as a long-term educational strategy.

An investigation on information quality, media richness, and social media fatigue during the disruptions of COVID-19 pandemic

Mobile social platforms have become a valuable information source by which users gain information about the COVID-19 pandemic. However, little is known about whether users have experienced increased daily fatigue as a result of the disruptions caused by pandemic. Drawing on the cognitive activation theory of stress (CATS), this study proposed that two typical characteristics of social media platforms (SMP), information quality and media richness, are associated with event disruptions of the COVID-19 pandemic (EDC), and then induce social media fatigue. To address this, this study used the experience sampling method (ESM), collecting 550 matched cases from 110 users of the WeChat application in mainland China over five consecutive days. Through multilevel structural equation modeling (MSEM), this study discovered three main findings: (1) daily information quality is negatively related to event disruptions of the COVID-19 pandemic, which in turn decreases daily social media fatigue; (2) daily media richness is positively associated with such event disruptions, which ultimately increases daily social media fatigue; (3) these effects were stronger for users who reported higher (vs. lower) levels of health consciousness. The implications of these results for the COVID-19 pandemic and beyond are discussed.

How users make judgements about the quality of online health information: a cross-sectional survey study

BACKGROUND

People increasingly use the Internet to seek health information. However, the overall quality of online health information remains low. This situation is exacerbated by the unprecedented "infodemic", which has had negative consequences for patients. Therefore, it is important to understand how users make judgements about health information by applying different judgement criteria.

OBJECTIVE

The objective of this study is to determine how patients apply different criteria in their judgement of the quality of online health information during the pandemic. In particular, we investigate whether there is consistency between the likelihood of using a particular judgement criterion and its perceived importance among different groups of users.

METHODS

A cross-sectional survey was conducted in one of the leading hospitals in a coastal province of China with a population of forty million. Combined-strategy sampling was used to balance the randomness and the practicality of the recruiting process. A total of 1063 patients were recruited for this study. Chi-square and Kruskal-Wallis analyses were used to analyse the survey data.

RESULTS

In general, patients make quality judgement of health information more frequently based on whether it is familiar, aesthetic, and with expertise. In comparison, they put more weights on whether health information is secure, trustworthy, and with expertise when determining its quality. Criteria that were considered more important were not always those with a higher likelihood of being used. Patients may not use particular criteria, such as familiarity, identification, and readability, more frequently than others even if they consider them to be more important than other do and vice versa. Surprisingly, patients with a primary school degree put more weight on whether health information is comprehensive than those with higher degrees do in determining its quality. However, they are less likely to use this guideline in practice.

CONCLUSIONS

To the best of our knowledge, this is the first study to investigate the consistency between the likelihood of using certain quality judgement criteria and their perceived importance among patients grouped by different demographic variables and eHealth literacy levels. The findings highlight how to improve online health information services and provide fine-grained customization of information for users.

Performance expectancy of E-learning on higher institutions of education under uncertain conditions: Indonesia context

Performance expectancy is the expected impact of a technology's functional advantage even in uncertain conditions. This study suggests that the learning collaboration quality, information quality, and course content support impact the actual use of e-learning and satisfaction perceived by the user, resulting in performance expectancy that meets stakeholder expectations. This study outlines the theoretical model for defining student success in e-learning systems through a theory of online collaborative learning. The research examines the empirical data gathered from 109 postgraduate doctoral students' participated in the postgraduate universities in Indonesia. The research attempts to focus specifically on how the actual use of e-learning and satisfaction perceived by users mediates the influence of learning collaboration quality, information quality, and course content support on performance expectancy to enhance the sustainability and performance of e-learning in Indonesian universities. The study shows that the learning collaboration quality, information quality, and course content support have no impact on performance expectancy, while each of the constructs indirectly impacts the performance expectancy through the actual use of e-learning. Conversely, the learning collaboration quality and course content support have not indirectly influenced toward performance expectancy by satisfaction perceived by the user as mediator except the information quality.

Internet Information on Oral Cancer Drugs: a Critical Comparison between Website Providers

Cancer patients need access to high-quality information, when making decisions about oral cancer drugs. The internet is often used as a source of information published by highly heterogeneous providers. The objective was to evaluate the quality of website providers supplying online information about oral cancer drugs. One hundred websites were analyzed using content-related and formal criteria, selected from three existing evaluation methods used for cancer websites, for medical information (defined by the German Agency for Quality in Medicine), and for the "fact box" tool. A web search by a patient was simulated to identify websites to evaluate. ANOVA was used to assess information provided by non-profit organizations (governmental and non-governmental), online newspapers, for-profit organizations, and private/unknown providers. Content-related quality differences were found between online newspapers and all other categories, with online newspapers ranking significantly lower than for-profit and non-profit websites. As for formal criteria, for-profit providers scored significantly lower than non-profit providers and online newspapers for the aspect of transparency. Internet information on oral cancer drugs published by non-profit organizations constitutes the best available web-based source of information for cancer patients. Health literacy and e-health literacy should be promoted in the public domain to allow patients to reliably apply web-based information. Certification should be required by law to ensure fulfillment of requirements for data reliability and transparency (authorship and funding) before health professionals recommend websites to cancer patients.

Exploring the information quality of mobile government services: a literature review

This article aims to investigate the constructs that can be used to evaluate the information quality (IQ) of mobile government services. The dimension of IQ is one of the fundamental constructs that assesses the extent of information based on its accuracy, usefulness, and timeliness. Based on the review of previous studies, there is a lack of studies related to mGovernment service quality. It is not practical to measure the service quality of mGovernment by using other measurement scales such as e-service, e-commerce, or e-government. Therefore, it is necessary to understand each dimension that guides constructing a comprehensive framework to measure service quality at mGovernment. The constructs of information quality were extracted from previous literature in mobile government, mobile application service, and e-government to understand the development stages, structure, and unique features-this guide to conduct the systematic literature review to clarify the constructs belonging to the evaluation of information quality. The present article identified six constructs-understandability, timeliness, accuracy, completeness, availability, and usefulness-to measure the information quality of mobile government service. There is limited literature on mGovernment information service quality. With the development of government services on mobile devices, it is necessary to measure information quality at mGovernment service channel to understand users' expectations. The mGovernment service provider benefits from measuring the service quality by improving the strategy and criteria of information at mGovernment portal. In addition, the end-users expect to perform the service with the best quality level of the information supplied and displayed on mGovernment platform.

[Contraception in the German-language Wikipedia: a content and quality analysis]

BACKGROUND

Adolescents and adults today often obtain information about contraception from the Internet, especially from the online encyclopedia Wikipedia. This is because Google searches usually return Wikipedia entries as top hits.

RESEARCH AIM

Against this background, the aim of the current study is to systematically analyze for the first time the content and quality of Wikipedia articles on contraceptive methods. Five central quality dimensions are examined: the degree of correctness (research question RQ1), completeness (RQ2), neutrality (RQ3), comprehensibility (RQ4), and currency (RQ5) of the contraceptive information - and on this basis the overall quality of the articles (RQ6).

MATERIALS AND METHODS

A sample of all German-language Wikipedia articles on all contraceptive methods was formed (N = 25). These articles were analyzed by three independent, trained coders using a codebook that was developed based on the current state of the research and tested for reliability. Data analysis was performed using SPSS. The study is preregistered and all data, materials, and analysis scripts are publicly available.

RESULTS

The 25 Wikipedia articles on contraceptive methods were found to vary widely in content quality. While they showed good quality on average in terms of correctness (RQ1) and neutrality (RQ3), they scored mediocre in terms of completeness (RQ2), comprehensibility (RQ4), and currency (RQ5), resulting in moderate overall quality (RQ6).

DISCUSSION

More research as well as practice measures are needed to further assess and improve the quality of contraceptive information on Wikipedia and in other social media in a more targeted way.

Do anxiety websites have the answers people are looking for?

OBJECTIVES AND METHODS: A wealth of online anxiety information exists but much of it is not evidence-based or well-balanced. This study evaluated anxiety websites (N = 20) on readability, quality, usability, visual design, and content.

RESULTS

Overall, websites were of reasonable quality but only half were considered understandable according to the PEMAT usability scale (70% cutoff value). The average reading level across websites was 11.2 (SMOG), which is higher than NIH recommended grade 6-7 level. Websites had variable design features and a trending association suggested websites with better design come up earlier in search results. The number of topics covered varied across websites and most did not adequately cover all topics of interest. Most websites included information about psychological and self-help treatments, how treatment works, and what treatment entails. The Top 5 websites were: (1) Anxiety BC, (2) ADAA, (3) Mind, (4) Beyond Blue, and (5) Web MD.

CONCLUSIONS

This is the first study to evaluate existing anxiety information websites based on the dimensions described above and their relationship to Google search results.

PRACTICE IMPLICATIONS

This study highlights the importance of considering several dimensions in developing mental health resources and provides direction for strategies to improve existing websites and/or develop new resources.

An evaluation of the quality of online perinatal depression information

BACKGROUND

During the perinatal period (including pregnancy and up to 12 months after childbirth), expectant and new mothers are at an elevated risk of developing depression. Inadequate knowledge about perinatal depression and treatment options may contribute to the low help-seeking rates exhibited by perinatal people. The Internet can be an accessible source of information about perinatal depression; however, the quality of this information remains to be evaluated. The purpose of this study was to assess the quality of perinatal depression information websites.

METHODS

After review, 37 websites were included in our sample. To assess overall website quality, we rated websites based on their reading level (Simple Measure of Gobbledegook; SMOG), information quality (DISCERN), usability (Patient Education Materials Assessment Tool; PEMAT), and visual design (Visual Aesthetics of Website Inventory; VisAWI).

RESULTS

Websites often exceeded the National Institute of Health's recommended reading level of grades 6-8, with scores ranging from 6.8 to 13.5. Website information quality ratings ranged from 1.8 to 4.3 out of 5, with websites often containing insufficient information about treatment choices. Website usability ratings were negatively impacted by the lack of information summaries, visual aids, and tangible tools. Visual design ratings ranged from 3.2 to 6.6 out of 7, with a need for more creative design elements to enhance user engagement.

CONCLUSIONS

This study outlines the characteristics of high-quality perinatal depression information websites. Our findings illustrate that perinatal depression websites are not meeting the needs of users in terms of reading level, information quality, usability, and visual design. Our results may be helpful in guiding healthcare providers to reliable, evidence-based online resources for their perinatal patients.

Official social media and its impact on public behavior during the first wave of COVID-19 in China

BACKGROUND

During the COVID-19 pandemic, official social media became a critical channel for the public to obtain pandemic information. No matter the positive function or negative effect of information dissemination, it involves the public's risk perception and behavior. This study was designed to contribute to the existing research on how official social media information quality (IQ) and risk perception (RP) affect preventive behavior (PB) and continued use behavior (CB) of official social media during the first wave of COVID-19.

METHODS

The required data were extracted from a national online survey of the Chinese Mainland during March 24-30 2020, a random sample was asked to participate in the survey (n = 666). Data analysis was performed using regression analysis, structural equation modeling, mediating effect analysis, and one-way ANOVA analysis.

RESULTS

The results show that IQ (10.010 ± 3.568) has direct and indirect positive impact on PB (9.475 ± 3.571), and has a low significant positive indirect impact on CB (3.739 ± 1.566). The IQ has a significant positive impact on RP (β = 0.548), which show that there is no "risk perception paradox" in COVID-19. Furth more, this study also provides new evidence indicating that RP mediates the relationship between IQ and PB. According to the region, gender, age and annual income, and there are significant differences in PB and CB.

CONCLUSION

The study findings have remarkable implications for improving the information quality and public behaviors. Too high or too low level of risk perception is not conducive to pandemic prevention and control. Official social media should indirectly affect information flow through the reasonable supply of pandemic information and constantly improve the quality of pandemic information to avoid public's undue panic and excessive health concerns during this ongoing outbreak and subsequent national public emergency events.

Content and Quality of Information about Stroke in Wikipedia across Multiple Languages

BACKGROUND

Given the high contribution of stroke to the global burden of disease, there is a need for good-quality information on Web platforms such as Wikipedia.

AIMS

This study aimed to describe the quality of the Wikipedia articles on stroke written in different languages.

METHODS

We studied the world's 30 most spoken languages. With the DISCERN score, we evaluated the quality of the information within the Wikipedia articles. Three investigators assessed each of the texts translated to English. We also registered the word count, the number of references, and if the text referred to the emergency status of stroke, cues to suspect a stroke, and allusions to endovascular treatment.

RESULTS

There is a Wikipedia article for stroke in 23 out of the 30 languages. The mean DISCERN score was 35 29.9 ± 9.2. Overall quality ranged from 3/5 in 26.1% to 1/5 in 17.4%. Word count had a mean of 36 3,145.8 ± 3,048.9 words, and the texts included a mean of 43.1 ± 57.3 references; 69.6% of the articles referred to stroke as a medical emergency, 52.2% included awareness symptoms, and 34.8% included endovascular management among the stroke treatments. Three pages included steroids as part of the stroke treatment. The DISCERN score was not correlated with the number of speakers, but it was positively correlated with the number of references (r = 0.90, p < 0.001) and the number of words (r = 0.78, p < 0.001) in the articles.

CONCLUSION

The analyzed Wikipedia articles do not contain relevant and up-to-date information to the general population. Further, the content varies widely across the different languages and is missing for some of them. The missing versions disproportionally affect millions of potential information seekers in undeveloped countries.

Augmenting perception: How artificial intelligence transforms sensory substitution

What happens when artificial sensors are coupled with the human senses? Using technology to extend the senses is an old human dream, on which sensory substitution and other augmentation technologies have already delivered. Laser tactile canes, corneal implants and magnetic belts can correct or extend what individuals could otherwise perceive. Here we show why accommodating intelligent sensory augmentation devices not just improves but also changes the way of thinking and classifying former sensory augmentation devices. We review the benefits in terms of signal processing and show why non-linear transformation is more than a mere improvement compared to classical linear transformation.

Assessing the quality of COVID-19 vaccine videos on video-sharing platforms

Background

Video-sharing platforms are a common source for health information such as Coronavirus Disease 2019 (COVID-19) vaccines. It is important that they provide good quality, evidence-based information. However, to date, the quality of information surrounding COVID-19 vaccines on video-sharing platforms has not been established.

Objective

This study developed an assessment tool to evaluate the quality of Coronavirus Disease 2019 (COVID-19) vaccine videos on YouTube, Facebook Watch and TikTok.

Methods

Assessment of quality was based on understandability, actionability, accuracy, comprehensiveness and reliability. Videos were searched using the keywords “COVID-19 vaccine”, “Coronavirus vaccine” and “SARS-CoV-2 vaccine”. Seventy-two videos were evaluated. Descriptive statistics, Kruskal-Wallis and Wilcoxon-rank sum tests were used for analysis.

Results

YouTube had the highest median composite score compared to TikTok (36.8% versus 27.5%, p = 0.001). YouTube also had the highest median reliability score (37.5%), but those of Facebook Watch (35.0%) and TikTok (35.0%) were only marginally lower. Median accuracy scores of all platforms were 100%, but their median comprehensiveness scores were low (YouTube 12.5%; Facebook Watch 6.3%; TikTok 6.3%, p = 0.004). Median actionability scores (0%) were the lowest for all platforms. TikTok had the highest median understandability score compared to YouTube and Facebook Watch (96.9% versus 80.0 each, p < 0.001).

Conclusion

The overall quality of videos on all video-sharing platforms were low. All platforms provided accurate COVID-19 vaccine information, but TikTok videos were the most understandable. Most videos did not provide full details about COVID-19 vaccines, thus viewers would need to watch several videos before making a better-informed decision.

Clinical researchers' lived experiences with data quality monitoring in clinical trials: a qualitative study

BACKGROUND

Fundamental to the success of clinical research that involves human participants is the quality of the data that is generated. To ensure data quality, clinical trials must comply with the Good Clinical Practice guideline which recommends data monitoring. To date, the guideline is broad, requires technology for enforcement, follows strict industry standards, mostly designed for drug-registration trials and based on informal consensus. It is also unknown what challenges clinical trials and researchers face in implementing data monitoring procedures. Thus, this study aimed to describe researcher experiences with data quality monitoring in clinical trials.

METHODS

We conducted semi-structured telephone interviews following a guided-phenomenological approach. Participants were recruited from the Australian and New Zealand Clinical Trials Registry and were researchers affiliated with a listed clinical study. Each transcript was analysed with inductive thematic analysis before thematic categorisation of themes from all transcripts. Primary, secondary and subthemes were categorised according to the emerging relationships.

RESULTS

Data saturation were reached after interviewing seven participants. Five primary themes, two secondary themes and 21 subthemes in relation to data quality monitoring emerged from the data. The five primary themes included: education and training, ways of working, working with technology, working with data, and working within regulatory requirements. The primary theme 'education and training' influenced the other four primary themes. While 'working with technology' influenced the 'way of working'. All other themes had reciprocal relationships. There was no relationship reported between 'working within regulatory requirements' and 'working with technology'. The researchers experienced challenges in meeting regulatory requirements, using technology and fostering working relationships for data quality monitoring.

CONCLUSION

Clinical trials implemented a variety of data quality monitoring procedures tailored to their situation and study context. Standardised frameworks that are accessible to all types of clinical trials are needed with an emphasis on education and training.

Information handoffs in critical care and their implications for information quality: A socio-technical network approach

OBJECTIVE

The design of health ICTs, as well as human factors, have been shown to influence patient information quality. The aim of this study was to understand how patterns of interaction between these factors influence information quality aspects in a critical care environment.

METHOD

We conducted an ethnographic study of socio-technical information handoffs in a critical care unit. Data collection methods included non-participant observations and semi-structured interviews. Methodological principles from network analysis (SNA, VNA) were used to develop visual network diagrams, as well as to analyze the composition of the information network and its influence on patient information quality.

RESULTS

The network patterns that emerged uncover that human actors have many information processing and dissemination roles at the critical care unit. However, ICTs play key network roles, acting as information intermediaries and gatekeepers. We further identify three types of information handoffs in the critical care environment - human-human, human-ICT and ICT-human. On the one hand, we find that human-human and ICT-human handoffs influence contextual and intrinsic aspects of patient information, such as information completeness and accuracy. On the other hand, human-ICT handoffs influence information accessibility and representational quality, such as consistency and interpretability.

DISCUSSION

The results suggest that standardizing change of shift handoff communication may not be sufficient to prevent information decay in complex care trajectories. In particular, we argue that ensuring information consistency and interpretability across disciplines and professions is as important as ensuring information completeness and accuracy during change of shift handoffs. ICT and workflow design opportunities are discussed as means to address overlapping or conflicting information needs across disciplines and professions, increase information consistency, and reduce information redundancy across the network.

Testing the success of real-time online delivery channel adopted by higher education institutions in the United Arab Emirates during the Covid-19 pandemic

E-learning was mandated for all the higher education institutions (HEI) in the United Arab Emirates (UAE) to encounter the pandemic and practice social distancing in year 2020. This led education institutions to shift from face-to-face traditional classroom settings to online education channels for delivering education to their students despite being less familiar with the real-time remote learning. The current study attempts to measure the success of e-learning systems adopted by the HEIs in UAE. An e-learning system success measuring the framework based on DeLone and McLean (J Manage Inf Syst 19(4):9-30, 2003) was developed including the measures of quality, system use, perceptual benefits and future outcomes from students' perspective. A survey was conducted from more than 1200 students studying at different higher education institutions of the UAE region. The findings have implications for educators and policy-makers recommending the success factors of e-learning delivery channels in this region.

[Management of Non-Financial Risks: A Research Agenda]

Das Management nicht-finanzieller Risiken wie ESG-, Nachhaltigkeits- und Compliance-Risiken stellt Unternehmen vor große Herausforderungen. Im Gegensatz zu finanziellen Risiken ist zu nicht-finanziellen Risiken nur wenig Information verfügbar. Dies erschwert ein effektives Management erheblich. Unternehmen haben in den letzten Jahren hohe Verluste durch nicht-finanzielle Risiken erlitten. Die Corporate Governance dieser Risiken wirft zahlreiche, ungelöste Fragen auf. Dieser Beitrag skizziert mögliche Lösungsansätze und Thesen zum Einfluss der Informationsqualität. Bei diesen Fragen fühlt sich die Praxis von den Hochschulen allein gelassen. Eine Kooperation von Praxis und Hochschule zur Lösung der Fragen eröffnet attraktive Forschungsfelder für Hochschulen. Daher zeigt dieser Beitrag auch eine Forschungsagenda für Hochschulen auf.

Effects of COVID-19 in E-learning on higher education institution students: the group comparison between male and female

In response to the emerging and ever solution to the COVID-19 outbreak. This study proposes a theoretical framework based on literature and model to determined E-learning portal success. The study compared males and females to E-learning portal usage. The study objective is to check the difference between male and female E-learning portals’ accessibility among the students’ perspective. The study included service quality, system quality, information quality, user satisfaction, system use, and E-learning portal success. The empirical data of 280 students participated from the different universities of Malaysia through google surveys analyzed using the Partial Least Squares Structural Equation Modelling. The study further divided the full model into two domains, which are female and male. In the male model, information quality and system quality have direct relationships with user satisfaction. Information quality also supported the relationship with system use. At the same time, there is a positive relationship between user satisfaction and E-learning portals. Likewise, in the female model, E-service quality and Information quality both are supported by system use and user satisfaction. Similarly, system quality has a positive relationship with user satisfaction, and user satisfaction has a positive relationship with E-learning portals. The study will be further helpful for the Malaysian universities policy-makers such as top management, ministry of higher education, Malaysian universities union in designing the policies and programs on E-learning Portal Success in the country. The findings of the study reveal that males and females have a different level of in terms of usage of towards E-learning portals in Malaysian Universities.

AutoDiscern: rating the quality of online health information with hierarchical encoder attention-based neural networks

Background

Patients increasingly turn to search engines and online content before, or in place of, talking with a health professional. Low quality health information, which is common on the internet, presents risks to the patient in the form of misinformation and a possibly poorer relationship with their physician. To address this, the DISCERN criteria (developed at University of Oxford) are used to evaluate the quality of online health information. However, patients are unlikely to take the time to apply these criteria to the health websites they visit.

Methods

We built an automated implementation of the DISCERN instrument (Brief version) using machine learning models. We compared the performance of a traditional model (Random Forest) with that of a hierarchical encoder attention-based neural network (HEA) model using two language embeddings, BERT and BioBERT.

Results

The HEA BERT and BioBERT models achieved average F1-macro scores across all criteria of 0.75 and 0.74, respectively, outperforming the Random Forest model (average F1-macro = 0.69). Overall, the neural network based models achieved 81% and 86% average accuracy at 100% and 80% coverage, respectively, compared to 94% manual rating accuracy. The attention mechanism implemented in the HEA architectures not only provided ’model explainability’ by identifying reasonable supporting sentences for the documents fulfilling the Brief DISCERN criteria, but also boosted F1 performance by 0.05 compared to the same architecture without an attention mechanism.

Conclusions

Our research suggests that it is feasible to automate online health information quality assessment, which is an important step towards empowering patients to become informed partners in the healthcare process.

Technical indicators to improve municipal solid waste management in developing countries: A case in Mexico

Nowadays, increasingly complex sets of indicators are used to compare and diagnose municipal solid waste management (MSWM). These sets incorporate new priorities regarding sustainability and focus on measuring the progress to zero waste. Nevertheless, in developing countries, where MSWM is still striving to protect health from the potential impacts of waste, the MSWM information available is scarce and of low quality. This work proposes a basic set of indicators for analyzing technical aspects of street cleaning, waste collection and disposal in such contexts. Based on the assessment of 66 Mexican municipalities, ten indicators were identified that can be calculated with the information available. For each indicator, reference values were established, and their performance was evaluated by means of a traffic light system. In addition, a method that allows the quality of the information to be classified into four levels according to the data source, its uncertainty, the temporal coverage, and its spatial coverage was applied. The results obtained revealed an incipient implementation of MSWM and highlighted the need to increase the coverage of the collection services and to improve the conditions of the disposal sites in most of the municipalities that were studied. The proposed set of indicators can be used as a starting point to systematize the monitoring and detection of areas of improvement in the MSWM of the municipalities studied, as well as in other systems in similar contexts.

Policy over- and under-design: an information quality perspective

This article seeks to improve our understanding of what policy over- and under-design mean; what are the consequences of these suboptimal designs; and how politics matters to these designs. Based on the review of the literature and a variety of examples that focus on the role of information quality in policy design, and drawing on two phenomena from the field of epidemiology (namely, over-adjustment and unnecessary adjustment), the article enhances the definitional clarity of the terms under investigation and allows us to address the difficulty in reconciling technical problem solving with politics. The article proposes new definitional statements of proportionate and disproportionate policy designs that vary according to the extent to which the main design properties are adjusted to low-quality information. It also explores distinct variations in a few policy characteristics resulting from over- and under-design. The policy characteristics examined here include economic efficiency, policy effectiveness, policy robustness; the space for making significant changes at a later stage when high-quality information becomes available; the potential consequences in terms of policy over- and under-reaction; and the political ramifications of these suboptimal designs for elected executives. With regard to the interaction between technical and political logics, the article posits that deliberate policy over- and under-design can be viewed as solutions to serious political problems faced by elected executives, especially in politically sensitive times. Therefore, it facilitates a more realistic understanding of the conditions under which a policy is under- or over-designed to respond to some objectives but entirely proportionate with regard to others.

Quality and readability of online information on ankylosing spondylitis

INTRODUCTION/OBJECTIVE

Obtaining online health-related information is becoming increasingly popular among patients. The attainment of information through websites is easy and practical, but there is no mechanism to check the accuracy and quality of this information. This leads to concerns about information from websites. Therefore, we aimed to evaluate the quality and readability of ankylosing spondylitis-related websites in this study.

METHODS

This is a descriptive study. Websites were searched on a popular search engine with the search term ankylosing spondylitis on March 2, 2019. We recorded the URLs of the first 200 websites listed in the query results. Typologies, quality, and readability were evaluated on these websites. Websites were divided into eight categories (commercial, government, health portal, news, non-profit, professional, scientific journal, and others) according to typology. The JAMA scoring system and the presence of HONcode certification were used to assess the quality. The Flesch-Kincaid grade and the Simple Measure of Gobbledygook were used to evaluate the readability.

RESULTS

Of the websites analyzed, 46% were in the high-quality group. We found that scientific journals and news were of higher quality, and commercial and other websites were of poorer quality. The average readability grades of the websites were 8.59 ± 2.42 and 7.33 ± 1.54, which were slightly worse than the recommended value. Additionally, the readability grades were significantly higher on high-quality websites (p < 0.05).

CONCLUSION

The quality of information on websites is variable. High-quality information about ankylosing spondylitis is available online, particularly from scientific journals and news. The poor readability of websites that provide high-quality information is a problem for patients with low health literacy. Editors should take into account readability while aiming to present high-quality information on websites. Key Points • Websites have become an important source of health-related information in parallel with the increase in internet use. • Less than half of the ankylosing spondylitis-related websites (46%) were of high quality according to JAMA scores. • The average readability grades of the ankylosing spondylitis-related websites were slightly worse than the recommended values. • High-quality websites had higher readability grades. Therefore, high-quality websites may not be understood by patients with low literacy levels. • No significant difference was found between the websites on the first page (n = 10) and remaining websites (n = 102) in terms of quality and readability.

Information publicity and resident's waste separation behavior: An empirical study based on the norm activation model

Waste separation is beneficial to minimize the negative environmental effects of waste and to promote the recycling use of waste. Based on the norm activation model framework, this study mainly focused on examining how information publicity about waste separation affects resident's waste separation intention. A questionnaire survey was conducted in China to collect the research data, and the data were analyzed by using the structural equation modeling technique. The results indicated that resident's awareness of consequences of not separating waste is positively and significantly associated with ascription of responsibility, and both of them are positively and significantly related to personal norm. Personal norm is positively associated with resident's waste separation intention. Furthermore, information publicity has a direct and positive effect on resident's waste separation intention. However, the effect is relatively small. Meanwhile, it is worth noting that the effect of information publicity on waste separation intention depends on information quality. Information quality positively moderates the effect of information publicity on waste separation intention. The current study enriched the research on resident's waste separation behavior and highlighted the role of information publicity. Based on the results, policy implications about how to motivate residents to separate waste were discussed and the research limitations were pointed out.

Searching for answers: How well do depression websites answer the public's questions about treatment choices?

OBJECTIVE

The purpose of this study was to evaluate websites providing information on treatment for depression to the public, and to evaluate changes in the quality of website information over time.

METHODS

Websites (N = 25) addressing depression treatment were identified through the use of the Google search engine and by suggestions from healthcare professionals. Each website was evaluated based on the extent to which it addressed content areas deemed important by the public identified in previous research, overall quality as determined by the DISCERN, and reading level.

RESULTS

Overall, the quality of depression websites varied greatly. The majority of websites did not adequately answer the public's questions about treatment options, and presented higher quality information in the area of pharmacological treatments as compared to other treatment options. An average reading level of 10.0 was found across websites. Upon re-evaluation, only 14 of 25 websites added new content, and the majority of websites did not improve in their overall website quality (as measured by the DISCERN).

CONCLUSION AND PRACTICE IMPLICATIONS

Websites could be improved by addressing important questions that consumers have concerning depression, as well as by creating higher quality content in the areas of psychological, neurotherapeutic, and alternative treatments.

Evaluating the quality of perinatal anxiety information available online

The Internet is an easily accessible source of information for women experiencing anxiety in pregnancy and/or postpartum to use when seeking health information. However, the Internet has several drawbacks, including inaccurate content that may be perceived as being accurate, non-biased, and evidence-based. Prior research indicates that anxiety and postpartum mental health websites have poor quality in terms of describing treatment options. There is a lack of research and knowledge in the area of perinatal anxiety, and an absence of research evaluating perinatal anxiety websites. The purpose of this study was to evaluate the quality of information regarding perinatal anxiety available on the Internet. Websites concerning perinatal anxiety were selected using the Google search engine. Each website was evaluated based on quality of health information, website usability, and readability. The 20 websites included in this study had low to moderate quality scores based on the DISCERN tool. There were no associations found between website order and website quality, or between website readability and website quality. Many websites had high PEMAT scores for the understandability section, which included content, style, and layout of information; however, most did not use visual aids to enhance comprehension. Most websites had low actionability scores, suggesting that information may not be useful in describing what actions may be taken to manage perinatal anxiety. This study highlights the need for high-quality websites concerning perinatal anxiety that are easy to navigate and provide the public with evidence-based information.

The quality of information on the internet relating to top-selling dietary supplements in the Czech Republic

Background The purchase of dietary supplements (DS) via the Internet is increasing worldwide as well as in the Czech Republic. Objective The aim of the study is to evaluate the quality of information on DS available on the Internet. Setting Czech websites related to dietary supplements. Methods A cross-sectional study was carried out involving the analysis of information placed on the websites related to the 100 top-selling DS in the Czech Republic in 2014, according to IMS Health data. Main outcome measure The following criteria were evaluated: contact for the manufacturer, recommended dosage, information on active substances as well as overall composition, permitted health claims, % of the daily reference intake value (DRIV) for vitamins and minerals, link for online counseling, pregnancy/breastfeeding, allergy information, contraindications, adverse reactions, and supplement-drug interactions (some criteria were evaluated from both points of view). Results A total of 199 web domains and 850 websites were evaluated. From the regulatory point of view, all the criteria were fulfilled by 11.3% of websites. Almost 9% of the websites reported information referring to the treatment, cure, or prevention of a disease. From the clinical point of view, all the criteria were only met by one website. Conclusions The quality of information related to DS available on the Internet in the Czech Republic is quite low. The consumers should consult a specialist when using DS purchased online.

Analysis of the Information Quality of Bariatric Surgery Smartphone Applications Using the Silberg Scale

There is a paucity of literature that has evaluated the information quality of the current bariatric and obesity applications. Our objective was to evaluate the quality of currently available smartphone applications for bariatric-patient care using the Silberg scale. The two most widely used smartphone application online stores were searched in June 2014 and a total of 39 applications were evaluated. The average Silberg score of the 39 applications was 4.0 ± 1.76. The current gaps of information quality include the lack of provision of appropriate references, full disclosure of sponsorship, and accurate disclosure whether the application has been modified in the past month.

An importance-performance analysis of hospital information system attributes: A nurses' perspective

PURPOSE

Health workers have numerous concerns about hospital IS (HIS) usage. Addressing these concerns requires understanding the system attributes most important to their satisfaction and productivity. Following a recent HIS implementation, our objective was to identify priorities for managerial intervention based on user evaluations of the performance of the HIS attributes as well as the relative importance of these attributes to user satisfaction and productivity outcomes.

PROCEDURES

We collected data along a set of attributes representing system quality, data quality, information quality, and service quality from 154 nurse users. Their quantitative responses were analysed using the partial least squares approach followed by an importance-performance analysis. Qualitative responses were analysed using thematic analysis to triangulate and supplement the quantitative findings.

MAIN FINDINGS

Two system quality attributes (responsiveness and ease of learning), one information quality attribute (detail), one service quality attribute (sufficient support), and three data quality attributes (records complete, accurate and never missing) were identified as high priorities for intervention.

CONCLUSIONS

Our application of importance-performance analysis is unique in HIS evaluation and we have illustrated its utility for identifying those system attributes for which underperformance is not acceptable to users and therefore should be high priorities for intervention.

Impacts of structuring the electronic health record: a systematic review protocol and results of previous reviews

PURPOSE

This paper (1) presents the protocol of an on-going systematic literature review on the methods of structuring electronic health record (EHR) data and studying the impacts of implemented structures, thus laying basis for the analysis of the empirical articles (2) describes previous reviews published on the subject and retrieved during the search of bibliographic databases, and (3) presents a summary of the results of previous reviews.

METHODS

Cochrane instructions were exploited to outline the review protocol - phases and search elements. Test searches were conducted to refine the search. The abstracts and/or full texts of review papers captured by the search were read by two of the team members independently, with disagreements first negotiated between them and if necessary eventually resolved in the team meetings. Additional review articles were picked from the reference lists of the reviews included in our search results. The elements defined in the search strategy and analytic framework were converted to a data extraction tool, which was tested by extracting data from the reviews captured by the search. Descriptive analysis of the extracted data was conducted.

RESULTS

The 12-stage review protocol that we developed includes definition of the problem, the search strategy and search terms, testing the strategy, conducting the search, updating search from references found, removing duplicates, defining the inclusion and exclusion criteria, exclusion and inclusion of papers, definition of the analytic framework to extract data, extracting data and reporting results. Our searches in fifteen electronic bibliographic databases retrieved 27 reviews, of which 14 were included for full text analysis. Of these, 11 focused on medical and three on nursing record structures. The data structures included forms, ontologies, classifications and terminologies. Some evidence was found on data structure impact on information quality, process quality and efficiency, but not on patients or professionals.

CONCLUSIONS

The 12 step review protocol resulted in a variety of reviews of different ways to structure EHR data. None of them compared outcomes of different structuring methods; all had a narrower definition of the Intervention (a specific EHR structure) and Outcome (a specific impact category). Several reviews missed a clear connection between the data structures (interventions) and outcomes, indicating that the methods and applications for structuring patient data have rarely been viewed as independent variables. The review protocol should be defined in a manner that allows replication of the review. There are different ways of structuring patient data with varying impacts, which should be distinguished in further empirical studies, as well as reviews.