Showing papers by "Maged N. Kamel Boulos published in 2018"

Geospatial blockchain: promises, challenges, and scenarios in health and healthcare

Abstract: A PubMed query run in June 2018 using the keyword ‘blockchain’ retrieved 40 indexed papers, a reflection of the growing interest in blockchain among the medical and healthcare research and practice communities. Blockchain’s foundations of decentralisation, cryptographic security and immutability make it a strong contender in reshaping the healthcare landscape worldwide. Blockchain solutions are currently being explored for: (1) securing patient and provider identities; (2) managing pharmaceutical and medical device supply chains; (3) clinical research and data monetisation; (4) medical fraud detection; (5) public health surveillance; (6) enabling truly public and open geo-tagged data; (7) powering many Internet of Things-connected autonomous devices, wearables, drones and vehicles, via the distributed peer-to-peer apps they run, to deliver the full vision of smart healthy cities and regions; and (8) blockchain-enabled augmented reality in crisis mapping and recovery scenarios, including mechanisms for validating, crediting and rewarding crowdsourced geo-tagged data, among other emerging use cases. Geospatially-enabled blockchain solutions exist today that use a crypto-spatial coordinate system to add an immutable spatial context that regular blockchains lack. These geospatial blockchains do not just record an entry’s specific time, but also require and validate its associated proof of location, allowing accurate spatiotemporal mapping of physical world events. Blockchain and distributed ledger technology face similar challenges as any other technology threatening to disintermediate legacy processes and commercial interests, namely the challenges of blockchain interoperability, security and privacy, as well as the need to find suitable and sustainable business models of implementation. Nevertheless, we expect blockchain technologies to get increasingly powerful and robust, as they become coupled with artificial intelligence (AI) in various real-word healthcare solutions involving AI-mediated data exchange on blockchains.

Effective uses of social media in public health and medicine: a systematic review of systematic reviews

Abstract: Introduction: Research examining the effective uses of social media (SM) in public health and medicine, especially in the form of systematic r e views (SRs), has grown considerably in the past decade To our knowledge, no comprehensive synthesis of this literature has been conducted to date Aims and methods : To conduct a systematic review of systematic reviews of the benefits and harms (“effects”) of SM tools and platforms (such as Twitter and Facebook) in public health and medicine To perform a synthesis of this literature and create a ‘living systematic review’ Results: Forty-two (42) high-quality SRs were examined Overall, evidence of SM’s effectiveness in public health and medicine was judged to be minimal However, qualitative benefits for patients are seen in improved psychosocial support and psychological functioning Health professionals benefited from better peer-to-peer communication and lifelong learning Harms on all groups include the impact of SM on mental health, privacy, confidentiality and information reliability Conclusions: A range of negatives and positives of SM in public health and medicine are seen in the SR literature but definitive conclusions cannot be made at this time Clearly better research designs are needed to measure the effectiveness of social technologies For ongoing updates, see the wiki “Effective uses of social media in health: a living systematic review of systematic reviews” http://hlwikislaisubcca/indexphp/Effective_uses_of_social_media_in_healthcare:_a_living_systematic_review_of_reviews

Head-Mounted Virtual Reality and Mental Health: Critical Review of Current Research.

Abstract: Background: eHealth interventions are becoming increasingly used in public health, with virtual reality (VR) being one of the most exciting recent developments VR consists of a three-dimensional, computer-generated environment viewed through a head-mounted display This medium has provided new possibilities to adapt problematic behaviors that affect mental health VR is no longer unaffordable for individuals, and with mobile phone technology being able to track movements and project images through mobile head-mounted devices, VR is now a mobile tool that can be used at work, home, or on the move Objective: In line with recent advances in technology, in this review, we aimed to critically assess the current state of research surrounding mental health Methods: We compiled a table of 82 studies that made use of head-mounted devices in their interventions Results: Our review demonstrated that VR is effective in provoking realistic reactions to feared stimuli, particularly for anxiety; moreover, it proved that the immersive nature of VR is an ideal fit for the management of pain However, the lack of studies surrounding depression and stress highlight the literature gaps that still exist Conclusions: Virtual environments that promote positive stimuli combined with health knowledge could prove to be a valuable tool for public health and mental health The current state of research highlights the importance of the nature and content of VR interventions for improved mental health While future research should look to incorporate more mobile forms of VR, a more rigorous reporting of VR and computer hardware and software may help us understand the relationship (if any) between increased specifications and the efficacy of treatment

Gamification Concepts to Promote and Maintain Therapy Adherence in Children with Growth Hormone Deficiency

Abstract: Growth hormone (GH) deficiency affects up to one in 4000 children and is usually treated with daily injections of GH whilst the child is still growing With children typically diagnosed at around five years old, this can mean over 10 years of therapy, which can place a considerable burden on the child and the parent Over three-quarters of children are estimated to be not fully compliant with therapy, which can compromise their chances of attaining their target height In recent years, interactive mobile health (smart phone or tablet) interventions using game-like concepts, so called ‘gamification’, have increased in popularity and have demonstrated success in promoting positive self-management behaviour in children with chronic conditions, such as diabetes The application of gamified interventions has the potential to support adherence to therapy and positive behaviour in children with GH deficiency in a number of ways: (1) By providing education in a format that the child understands and accepts (eg, using behavioural constructs to facilitate explaining why adherence is important); (2) By providing a mechanism to reduce the anxiety and stress associated with administering the injection (eg, diversion with a virtual pet); and (3) By providing feedback to encourage ongoing engagement (eg, rewards, progression through levels)

Measuring management’s perspective of data quality in Pakistan’s Tuberculosis control programme: a test-based approach to identify data quality dimensions

Abstract: Data quality is core theme of programme’s performance assessment and many organizations do not have any data quality improvement strategy, wherein data quality dimensions and data quality assessment framework are important constituents. As there is limited published research about the data quality specifics that are relevant to the context of Pakistan’s Tuberculosis control programme, this study aims at identifying the applicable data quality dimensions by using the ‘fitness-for-purpose’ perspective. Forty-two respondents pooled a total of 473 years of professional experience, out of which 223 years (47%) were in TB control related programmes. Based on the responses against 11 practical cases, adopted from the routine recording and reporting system of Pakistan’s TB control programme (real identities of patient were masked), completeness, accuracy, consistency, vagueness, uniqueness and timeliness are the applicable data quality dimensions relevant to the programme’s context, i.e. work settings and field of practice. Based on a ‘fitness-for-purpose’ approach to data quality, this study used a test-based approach to measure management’s perspective and identified data quality dimensions pertinent to the programme and country specific requirements. Implementation of a data quality improvement strategy and achieving enhanced data quality would greatly help organizations in promoting data use for informed decision making.

Data Quality: A Negotiator between Paper-Based and Digital Records in Pakistan’s TB Control Program

Abstract: Background: The cornerstone of the public health function is to identify healthcare needs, to influence policy development, and to inform change in practice. Current data management practices with paper-based recording systems are prone to data quality defects. Increasingly, healthcare organizations are using technology for the efficient management of data. The aim of this study was to compare the data quality of digital records with the quality of the corresponding paper-based records using a data quality assessment framework. Methodology: We conducted a desk review of paper-based and digital records over the study duration from April 2016 to July 2016 at six enrolled tuberculosis (TB) clinics. We input all data fields of the patient treatment (TB01) card into a spreadsheet-based template to undertake a field-to-field comparison of the shared fields between TB01 and digital data. Findings: A total of 117 TB01 cards were prepared at six enrolled sites, whereas just 50% of the records (n = 59; 59 out of 117 TB01 cards) were digitized. There were 1239 comparable data fields, out of which 65% (n = 803) were correctly matched between paper based and digital records. However, 35% of the data fields (n = 436) had anomalies, either in paper-based records or in digital records. The calculated number of data quality issues per digital patient record was 1.9, whereas it was 2.1 issues per record for paper-based records. Based on the analysis of valid data quality issues, it was found that there were more data quality issues in paper-based records (n = 123) than in digital records (n = 110). Conclusion: There were fewer data quality issues in digital records as compared with the corresponding paper-based records of tuberculosis patients. Greater use of mobile data capture and continued data quality assessment can deliver more meaningful information for decision making.

Gamification Concepts to Promote and Maintain Therapy Adherence in Children with Growth Hormone Deficiency

Abstract: Growth hormone (GH) deficiency affects up to one in 4000 children and is usually treated with daily injections of GH whilst the child is still growing. With children typically diagnosed at around five years old, this can mean over 10 years of therapy, which can place a considerable burden on the child and the parent. Over three-quarters of children are estimated to be not fully compliant with therapy, which can compromise their chances of attaining their target height. In recent years, interactive mobile health (smart phone or tablet) interventions using game-like concepts, so called ‘gamification’, have increased in popularity and have demonstrated success in promoting positive self-management behaviour in children with chronic conditions, such as diabetes. The application of gamified interventions has the potential to support adherence to therapy and positive behaviour in children with GH deficiency in a number of ways: (1) By providing education in a format that the child understands and accepts (e.g., using behavioural constructs to facilitate explaining why adherence is important); (2) By providing a mechanism to reduce the anxiety and stress associated with administering the injection (e.g., diversion with a virtual pet); and (3) By providing feedback to encourage ongoing engagement (e.g., rewards, progression through levels).

A Framework for Improving the Engagement of Medical Practitioners in an E-Training Platform for Tuberculosis Care and Prevention

Abstract: We propose a new framework to improve the engagement of medical practitioners in a planned e-training platform for the successful identification and effective management of presumptive cases of tuberculosis (TB) in Pakistan. Our work is aligned with the World Health Organization’s TB-DOTS (Directly Observed Treatment Short-course) strategy for promoting the effective management of tuberculosis. We start by presenting previous work done at Mercy Corps Pakistan for training medical practitioners, then present the results of a recent survey we administered to a random sample of medical practitioners in Pakistan to learn about their requirements and readiness to embrace a new e-training platform and methodology. Informed by feedback from the survey, we formulated a detailed requirement analysis of the five key learning areas (or phases) that we believe are fundamental to the success of a TB e-training platform. Moreover, survey results revealed that an on-spot, on-demand, and competency-based learning tool can potentially improve the engagement of medical practitioners in the process. Building on the insights gained from the survey, we finally describe our initial UX (user experience) prototypes for phase 1, which corresponds to the identification of presumptive tuberculosis cases.