Biomedical informatics: characterization of the offer of massive open online courses

Introduction: Informatics applied to health sciences has brought cutting-edge solutions to healthcare problems. However, the number of health professionals trained in "Health Informatics" is low. Virtual education, such as massive online open courses, provide the opportunity for training in this field. Objective: To estimate the global offer of massive online open biomedical informatics courses and characterize their content. Methods: A search for massive online open courses was conducted throughout December 2021 on 25 platforms offering these courses. The search strategy included the terms "health informatics" and "biomedical informatics". The application areas of biomedical informatics, platform, institution, duration, time required per week, language, and subtitles available for each course were evaluated. Data were analyzed descriptively, reporting absolute and relative frequencies. Results; Our search strategy identified 1333 massive online open courses. Of these, only 79 were related to health informatics. Most of these courses (n = 44; 55.7%) were offered through Coursera. More than half (n = 55; 69.6%) were conducted by U.S. institutions in english (n = 76; 96.2%). Most courses focused on areas of translational bioinformatics (n = 27; 34.2%), followed by public health informatics (n = 23; 29.1%), and clinical research informatics (n = 13, 16.5%). Conclusions: We found a significant supply of massive online open courses on health informatics. These courses favor the training of more professionals worldwide, mostly addressing competencies to apply informatics in clinical practice, public health, and health research.

Stroke-related length of hospitalization trends and in-hospital mortality in Peru

Background

Peru faces challenges to provide adequate care to stroke patients. Length of hospitalization and in-hospital mortality are two well-known indicators of stroke care. We aimed to describe the length of stay (LOS) of stroke in Peru, and to assess in-hospital mortality risk due to stroke, and subtypes.

Methods

This retrospective cohort study used hospitalization registries coding with ICD-10 from 2002 to 2017 (N = 98,605) provided by the Ministry of Health; in-hospital mortality was available for 2016-2017 (N = 6,566). Stroke cases aged ≥35 years were divided into subarachnoid hemorrhage (I60), intracerebral hemorrhage (I61), cerebral infarction (I63), and stroke not specified as hemorrhage or infarction (I64). Data included stroke LOS and in-hospital mortality; socio-demographic and clinical variables. We fitted a region- and hospital level-stratified Weibull proportional hazard model to assess the in-hospital mortality.

Results

The median LOS was 7 days (IQR: 4-13). Hemorrhagic strokes had median LOS longer than ischemic strokes and stroke not specified as hemorrhage or infarction (P = <0.001). The case fatality rate (CFR) of patients with stroke was 11.5% (95% CI [10-12%]). Subarachnoid hemorrhage (HR = 2.45; 95% CI [1.91-3.14]), intracerebral hemorrhage (HR = 1.95; 95% CI [1.55-2.46]), and stroke not specified as hemorrhage or infarction (HR = 1.45; 95% CI [1.16-1.81]) were associated with higher in-hospital mortality risk in comparison to ischemic strokes.

Discussion

Between 2002 and 2017, LOS due to stroke has not changed in Peru in stroke patients discharged alive. Hemorrhagic cases had the longest LOS and highest in-hospital mortality risk during 2016 and 2017. The findings of our study seem to be consistent with a previous study carried out in Peru and similar to that of HIC and LMIC, also there is an increased median LOS in stroke cases managed in specialized centers. Likewise, LOS seems to depend on the type of stroke, where ischemic stroke cases have the lowest LOS. Peru needs to improve access to stroke care.

Going digital: opportunities and barriers in the use of technology for health research

Digital health refers to the use of novel information com­munication technologies in healthcare. The use of these technologies could positively impact public health and health outcomes of populations by generating timely data, and facili­tating the process of data collection, analysis, and knowledge translation. Using selected case studies, we aim to describe the opportunities and barriers in the use of technology applied to health-related research. We focus on three areas: strategies to generate new data using novel data collection methods, strategies to use and analyze existing data, and using digital health for health-related interventions. Exemplars from seven countries are provided to illustrate activity across these areas. Although the use of health-related technologies is increasing, challenges remain to support their adoption and scale-up –especially for under-served populations. Research using digital health approaches should take a user-centered design, actively working with the population of interest to maximize their uptake and effectiveness.

Diabetes care quality according to facility setting: A cross-sectional analysis in six Peruvian regions

OBJECTIVE

To characterize diabetes care across healthcare facilities in six Peruvian regions.

METHODS

Cross-sectional study of patients with type 2 diabetes mellitus (T2DM), ranging from primary care facilities to hospital-based facilities, in six Peruvian regions. Data was collected by health staff trained between 2012 and 2016. We studied six diabetes care outcomes and four adequate diabetes care outcomes considering the healthcare facility as the exposure of interest. We estimated prevalence ratios (PR) and their 95% confidence intervals (95% CI) using Poisson regression with robust variance.

RESULTS

Data from 8879 patients with T2DM, mean age 59.1 years (SD ± 12.2), 53.6% males, was analyzed. Of these, 8096 (91.2%) were treated at primary care facilities. The proportions of patients who had HbA1c, LDL-c, and creatinine/microalbumin test performed increased with the setting of the healthcare facility. Overall, 39%-56% of patients had an adequate HbA1c control, being higher in hospital-based facilities with specialists in comparison to primary care facilities.

CONCLUSIONS

We observed that the higher the setting of the facility, the higher the rate of the assessed diabetes care outcomes and adequate diabetes care for four of the six targets (fasting glucose, HbA1c, LDL-c and creatinine or microalbumin) and for three of the four targets (glucose≤130 mg/dL, HbA1c ≤7%(53 mmol/mol) and LDL-c <100 mg/dL), respectively. Substantial gaps were observed at the primary care facilities, calling for the strengthening of diabetes care.

Massive open online courses in health sciences from Latin American institutions: A need for improvement?

Background: Massive open online courses (MOOCs) have undergone exponential growth over the past few years, offering free and worldwide access to high-quality education. We identified the characteristics of MOOCs in the health sciences offered by Latin American institutions (LAIs).

Methods: We screened the eight leading MOOCs platforms to gather their list of offerings. The MOOCs were classified by region and subject. Then, we obtained the following information: Scopus H-index for each institution and course instructor, QS World University Ranking® 2015/16 of LAI, and official language of the course.

Results: Our search identified 4170 MOOCs worldwide. From them, 205 MOOCs were offered by LAIs, and six MOOCs were health sciences related. Most of these courses (n = 115) were offered through Coursera. One health science MOOC was taught by three instructors, of which only one was registered in Scopus (H-index = 0). The remaining five health science MOOCs had solely one instructor (H-index = 4 [0–17]). The Latin American country with the highest participation was Brazil (n = 11).

Conclusion: The contribution of LAI to MOOCs in the health sciences is low.

Where are we after 60 years of paragonimiasis research? A bibliometric assessment

Paragonimiasis is highly prevalent endemic food-borne disease in Southeast Asia and Latin America, and constitutes a major public health concern. A bibliometric analysis was performed about the worldwide scientific production of paragonimiasis. We browsed in the Science Citation Index-Expanded (SCI-E) (1957-2015), Scopus (1976-2015), Medline/PubMed/GoPubMed® (1970-2015), ScIELO (1981-2014) and LILACS (1985-2011). All types of articles were included and categorized by year of publication, number, type of scientific article, city and institution of origin, international cooperation, scientific journal, impact factor, language of publication, authors and H index. In SCI-E, 1,028 manuscripts were recovered, while Japan (21.9%) and the USA (17.7%) were the countries with highest scientific production. In this database, Asian region studies received 5,454 citations (H index=32). In Scopus 2161 items were recovered, corresponding to 45.8% of Asian countries. Japan (18.2%) was the first with the University of Miyazaki (11.7% of the country); South Korea (9.5%) was second with the Seoul National University (11.2% of the country). In SciELO 29 items were found, with no contributions from the Asian region. In LILACS 1487 articles were found (22.9% covering Asia). Among the databases, the Journal of Parasitology (Impact factor=1.227) showed the highest number of manuscripts and "Agatsuma T", from Japan, was the author with most records. Japan and South Korea lead global scientific production on paragonimiasis. By contrast, in Latin America, production has been extremely low especially in the last five years.