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International Journal of Technology Assessment in Health Care (review)

Perspectives in biology and medicine1987-09-01作者：Marc D. Silverstein

BOOK REVIEW InternationalJournal of Technology Assessment in Health Care. A newjournal edited by Egon Jonnson and Stanley J. Reiser. Quarterly, Cambridge University Press, London. Perhaps no specialty faces more acutely the problem of safely and effectively using new techniques and technologies, and the need to objectively and critically evaluate their performance, than intensive-care medicine. The new International Journal of Technology Assessment in Health Care has as its aims the "generation, evaluation, diffusion, and use of health care technology." The journal is intended for a diverse audience including health-care providers, decision makers in government, industry, health-care organizations, and scholarly disciplines of ethics, economics, law, history, sociology, and engineering. Does this journal have claim to the attention of the busy clinician who cares for critically ill patients ? Each issue is planned to contain a special section focused on a particular topic, general articles, and regular feature sections. The inaugural issue's special topic is technology and health care for the elderly, and this section includes articles on "Intensive Care for the Elderly," "Medical Technology for the Elderly inJapan," "End-stage Renal Failure and the Aged in the United Kingdom," "Orthopedic Technology for the Elderly," "Pacemakers," "Visual Rehabilitation for the Elderly through Improved Surgical Technology," "Neuronal Replacement after Traumatic or Age-dependent Brain Damage," "Audio-visual Programs in the Reality-Orientation Training of Alzheimer's Victims," and "Aspects of Psychological Aging and Technology." Two general essays in this issue are "Medical Technology Assessment: The Evaluation of Coronary Artery Bypass Graft Surgery Using Data Synthesis Techniques," and "Diagnosing Suspected Stroke: A Cost Effectiveness Analysis." The section on technology assessment reports on findings from the United States Office of Technology Assessment, the Clinical Efficacy Assessment Project of the American College of Physicians, the National Institutes of Health's Consensus Development Conference on Fresh Frozen Plasma, and the Swedish Medical Council and Swedish Planning and Rationalization Institute's Consensus Statement on Sight Improving Surgery. The emerging technology section has two articles on extracorporeal shock wave lithotripsy. Issues will contain regular sections on world perspectives, statistics, reviews, short reports, meetings and announcements, and a section entided the sorcerer's apprentice that will consider less formal topics including "parodies, satires, and other humorous items." Permission to reprint a book review printed in this section may be obtained only from the author. Perspectives in Biology and Medicine, 31, 1 ¦ Autumn 1987 \ 151 The article on "Intensive Care for the Elderly" by BryanJennett, M.D., of the University of Glasgow lists five categories of illness that bring adult patients to intensive-care units: myocardial infarction; postoperative care; respiratory, renal , or hepatic failure; coma; and hemorrhage or shock. He reviews studies of the outcome of intensive care and concludes "what such studies of outcome of intensive care indicate is that in patients whose outcome can be influenced, the details of the regimes and technologies matter less than the advantage that accrues from attracting the intensive attention of doctors and nurses." While it may be true that alternative therapeutic regimes can achieve similar outcomes, it is the intensivist's skillful attention to detail that achieves these outcomes. A framework for discussing controversial ethical issues in intensive-care decision making is outlined based on the principles of beneficence, nonmaleficence, patient autonomy, andjustice. The article is followed by two commentaries. David Barnard, Ph.D., of the Institute for Medical Humanities, University of Texas Medical Branch, elaborates on the partial truth of the equivalence of technical and moral excellence in medicine. A second commentary byJohannes O. Vang, M.D., Ph.D., of the Office of Health Technology Assessment of the World Health Organization places the economic cost of intensive care in the context of other technologies for health care and criticizes Dr. Jennett for omitting questions of discomfort, suffering, and dignity in intensive care. The article and commentaries are interesting and thought provoking, but their brevity limits their ability to elucidate the complex issues involved in intensive care. I would prefer longer articles with more attention to the subdeties that physicians face in their use of technologies for individual patients. Future issues will cover advanced technology and health care in the home, nuclear magnetic resonance, prenatal care, use and abuse of routine...

Economic Analysis of Health Care Technology: A Report on Principles

Annals of Internal Medicine1995-07-01作者：Task Force on Principles for Economic Analysis of Health Care Technology

Position Papers1 July 1995Economic Analysis of Health Care Technology: A Report on PrinciplesTask Force on Principles for Economic Analysis of Health Care Technology*Task Force on Principles for Economic Analysis of Health Care Technology*Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-123-1-199507010-00011 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail PreambleAlthough economic outcomes research is an evolving field in health services research, there are correct and incorrect ways to conduct and report on economic outcomes studies. Research practices that help to minimize real or perceived bias will increase the quality and usefulness of such studies for those who sponsor, publish, and use them. Because of public concerns about the potential for bias in the design, analysis, and reporting of economic analyses of health care technology, we formed a task force to develop principles to enhance the credibility of these studies. The Task Force on Principles for Economic Analysis of ...References1. Henry D. Economic analysis as an aid to subsidization decisions: the development of Australian guidelines for pharmaceuticals. PharmacoEconomics. 1992; 1:54-67. Google Scholar2. Detsky A. Guidelines for economic analysis of pharmaceutical products: a draft document for Ontario and Canada. PharmacoEconomics. 1993; 3:354-61. Google Scholar3. Udvarhelyi IS, Colditz GA, Rai A, Epstein AM. Cost-effectiveness and cost–benefit analyses in the medical literature. Are the methods being used correctly? Ann Intern Med. 1992; 116:238-44. Google Scholar4. Luce BR, Simpson K. Methods of cost effectiveness analysis: areas of consensus and debate. Clin Ther. 1995; 17:263-80. Google Scholar5. Drummond M, Brandt A, Luce B, Rovira J. Standardizing methodologies for economic evaluation in health care. Practice, problems, and potential. Int J Technol Assess Health Care. 1993; 9:26-36. Google Scholar6. Freedman B. Equipoise and the ethics of clinical research. N Engl J Med. 1987; 317:141-5. Google Scholar7. Uniform requirements for manuscripts submitted to biomedical journals. International Committee of Medical Journal Editors. JAMA. 1993; 269:2282-6. Google Scholar8. Angell M, Relman AS. Ethical imperialism? Fraud in biomedical research: a time for congressional restraint (Editorial). N Engl J Med. 1988; 318:1462-3. Google Scholar9. Engler RL, Covell JW, Friedman PJ, Kitcher PS, Peters RM. Misrepresentation and responsibility in medical research. N Engl J Med. 1987; 317:1383-9. Google Scholar10. Chalmers TC, Frank CS, Reitman D. Minimizing the three stages of publication bias. JAMA. 1990; 263:1392-5. Google Scholar11. Sharp DW. What can and should be done to reduce publication bias? The perspective of an editor. JAMA. 1990; 263:1390-1. Google Scholar12. Dickersin K. The existence of publication bias and risk factors for its occurrence. JAMA. 1990; 263:1385-9. Google Scholar13. Chalmers I. Underreporting research is scientific misconduct. JAMA. 1990; 263:1405-8. Google Scholar14. Schafer A. The ethics of the randomized clinical trial. N Engl J Med. 1982; 307:719-24. Google Scholar15. U.S. Public Health Service Panel on Cost-Effectiveness in Health and Medicine, Washington, D.C.: U.S. Public Health Service 1995. Google Scholar16. American Federation for Clinical Research National Council. American Federation for Clinical Research guidelines for avoiding conflict of interest. Clin Res. 1990; 38:239-40. Google Scholar17. Donaldson MS, Capron AM, eds. Patient Outcomes Research Teams: Managing Conflict of Interest. Washington, D.C.: National Academy Pr; 1991. Google Scholar18. American College of Physicians Ethics Manual. Part II: Research, other ethical issues. Recommended reading. Ad Hoc Committee on Medical Ethics, American College of Physicians. Ann Intern Med. 1984; 101:263-74. Google Scholar19. Institute of Medicine. The Responsible Conduct of Research in the Health Sciences: Report of a Study by a Committee on the Responsible Conduct of Research, Institute of Medicine, Division of Health Sciences Policy. Washington, D.C.: National Academy Pr; 1989. Google Scholar20. Korenman SG, Shipp AC. Teaching the Responsible Conduct of Research through a Case Study Approach: A Handbook for Instructors. Washington, D.C.: Association of American Medical Colleges; 1994; 191-5. Google Scholar21. Association of Academic Health Centers. Conflicts of Interest in Institutional Decision-Making: Task Force on Science Policy. Washington, D.C.: Association of Academic Health Centers; 1994. Google Scholar22. AFCR guidelines for the responsible conduct of research. Clin Res. 1989; 37:510-1. Google Scholar23. Harvard guidelines for investigators in scientific research. Clin Res. 1989; 37:192-3. Google Scholar24. Donaldson MS, Capron AM. Patient Outcome Research Teams: Managing Conflicts of Interest. Washington, D.C.: National Academy Pr; 1991. Google Scholar25. Hillman AL, Eisenberg JM, Pauly MV, Bloom BS, Glick H, Kinosian B, et al. Avoiding bias in the conduct and reporting of cost-effectiveness research sponsored by pharmaceutical companies. N Engl J Med. 1991; 324:1362-5. Google Scholar26. Drummond MF. Economic evaluation of pharmaceuticals: science or marketing? Pharmacoeconomics. 1992; 1:8-13. Google Scholar27. Freeman R. Health economics and strategic planning in pharmaceutical companies. Journal of Research in Pharmaceutical Economics. 1992; (In press). Google Scholar28. The Zitter Group. The HMO Outcomes Study. San Francisco: Center for Outcomes Information; 1991. Google Scholar29. Asch D. Opportunity and motive: conflicts of interest in industry-sponsored research. LDI Health Policy and Research Quarterly. 1981; 1:3. Google Scholar30. Kassirer JP, Angell M. The journal's policy on cost-effectiveness analyses (Editorial). N Engl J Med. 1994; 331:669-70. Google Scholar31. Hillman AL, Kim M. Decision-making in health care: discounting of life years revisited. PharmacoEconomics. 1994; 1995; 7:198-205. Google Scholar Author, Article, and Disclosure InformationAffiliations: Disclosure: The public announcement (at the time of a presentation or publication) of the evaluation and interpretation of the results of a study. Disclosure includes discussion of sources of possible bias, potential conflict of interest, relevant constraints imposed on investigators in their conduct or reporting of the study, the nature and amount of support received by the investigators, and other pertinent information necessary for full evaluation of the report.Corresponding Author: Alan L. Hillman, MD, MBA, Leonard Davis Institute of Health Economics, Center for Health Policy, University of Pennsylvania, 3641 Locust Walk, Philadelphia, PA 19104-6218.Disclaimer: Some of the views expressed in this report do not necessarily reflect those of all individual members of the Task Force or their affiliated organizations. Individual members did not officially represent the affiliated organizations. 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Bell, MDDevelopment of WHO guidelines on generalized cost-effectiveness analysisA review of economic evaluation in osteoporosisModeling economic evaluations of pharmaceuticals: manipulation or valuable tool?Raising the quality of cost-utility analyses: lessons learnt and still to learnIs health economics useful in cancer?Panel 3: Methodological Issues in Conducting Pharmacoeconomic Evaluations—Retrospective and Claims Database StudiesPanel 6: Addressing Questions of Bias, Credibility, and Quality in Health Economic EvaluationsResources Used by PanelistsEmerging standardization in pharmacoeconomicsState-of-the-art principles and practices of medical economicsHealth and Economic Outcomes Modeling Practices: A Suggested FrameworkToward Consistency in Cost-Utility AnalysesDoes a Clinical Trial Warrant an Economic Analysis?Economic analyses of radiological procedures: A methodological evaluation of the medical literatureEvaluating and Regulating Pharmacoeconomic Information in the Private SectorPharmacoeconomics and Managed CarePaying the Piper for Pharmacoeconomic StudiesHealth Services ResearchA Systematic Review of the Cost-Effectiveness of Noncardiac Transitional Care UnitsA summary of economic evaluations published in the field of rheumatology and related disciplinesEconomic evaluations of drug therapy: attitudes of primary care prescribing advisers in Great BritainEconomic Implications of Hepatic Arterial Infusion Chemotherapy in Treatment of Nonresectable Colorectal Liver MetastasesTHE PERSPECTIVE OF A PHARMACOECONOMIC STUDY: TARGETING FOR AUDIENCESCost-Effectiveness of Thrombolytic Therapy for Acute Myocardial InfarctionLong-term cost-effectiveness of alternative management strategies for patients with life-threatening ventricular arrhythmiasCost-Effectiveness of Anterotemporal Lobectomy in Medically Intractable Complex Partial EpilepsyThe Socio-economic Burden of Musculoskeletal InfectionsEvaluating the value of genomic diagnostics: Implications for clinical practice and public policy 1 July 1995Volume 123, Issue 1Page: 61-70KeywordsClinical trialsConflicts of interestFood and Drug AdministrationHealth careHealth care policyHealth economicsInformation storage and retrievalPrevention, policy, and public healthQuality of lifeResearch reporting guidelines ePublished: 15 August 2000 Issue Published: 1 July 1995 Copyright & PermissionsCopyright © 1995 by American College of Physicians. 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Economics and Econometrics Economics and Econometrics Economics and Econometrics

An updated coronary risk profile. A statement for health professionals.

Circulation1991-01-01作者：Keaven M. Anderson, P W Wilson, Patricia M. Odell

HomeCirculationVol. 83, No. 1An updated coronary risk profile. A statement for health professionals. Free AccessAbstractPDF/EPUBAboutView PDFSections ToolsAdd to favoritesDownload citationsTrack citationsPermissions ShareShare onFacebookTwitterLinked InMendeleyReddit Jump toFree AccessAbstractPDF/EPUBAn updated coronary risk profile. A statement for health professionals. K M Anderson, P W Wilson, P M Odell and W B Kannel K M AndersonK M Anderson Office of Scientific Affairs, American Heart Association, Dallas, TX 75231. , P W WilsonP W Wilson Office of Scientific Affairs, American Heart Association, Dallas, TX 75231. , P M OdellP M Odell Office of Scientific Affairs, American Heart Association, Dallas, TX 75231. and W B KannelW B Kannel Office of Scientific Affairs, American Heart Association, Dallas, TX 75231. Originally published1 Jan 1991https://doi.org/10.1161/01.CIR.83.1.356Circulation. 1991;83:356–362 Previous Back to top Next FiguresReferencesRelatedDetailsCited By Hespe C, Giskes K, Harris M and Peiris D (2022) Findings and lessons learnt implementing a cardiovascular disease quality improvement program in Australian primary care: a mixed method evaluation, BMC Health Services Research, 10.1186/s12913-021-07310-6, 22:1, Online publication date: 1-Dec-2022. Lemke E, Vetter V, Berger N, Banszerus V, König M and Demuth I (2022) Cardiovascular health is associated with the epigenetic clock in the Berlin Aging Study II (BASE-II), Mechanisms of Ageing and Development, 10.1016/j.mad.2021.111616, 201, (111616), Online publication date: 1-Jan-2022. Wong N, Budoff M, Ferdinand K, Graham I, Michos E, Reddy T, Shapiro M and Toth P (2022) Atherosclerotic cardiovascular disease risk assessment: An American Society for Preventive Cardiology clinical practice statement, American Journal of Preventive Cardiology, 10.1016/j.ajpc.2022.100335, 10, (100335), Online publication date: 1-Jun-2022. Coller J, Gong F, McGrady M, Shiel L, Liew D, Stewart S, Owen A, Krum H, Reid C, Prior D and Campbell D (2021) Risk factors for asymptomatic echocardiographic abnormalities that predict symptomatic heart failure, ESC Heart Failure, 10.1002/ehf2.13695, 9:1, (196-212), Online publication date: 1-Feb-2022. Mittal M, McEniery C, Supramaniam P, Cardozo L, Savvas M, Panay N and Hamoda H (2022) Impact of micronised progesterone and medroxyprogesterone acetate in combination with transdermal oestradiol on cardiovascular markers in women diagnosed with premature ovarian insufficiency or an early menopause: a randomised pilot trial, Maturitas, 10.1016/j.maturitas.2022.01.012, 161, (18-26), Online publication date: 1-Jul-2022. Adikari D, Gharleghi R, Zhang S, Jorm L, Sowmya A, Moses D, Ooi S and Beier S (2022) A new and automated risk prediction of coronary artery disease using clinical endpoints and medical imaging-derived patient-specific insights: protocol for the retrospective GeoCAD cohort study, BMJ Open, 10.1136/bmjopen-2021-054881, 12:6, (e054881), Online publication date: 1-Jun-2022. Disouza J, Patil K, Kakade P and Patravale V (2022) Dietary Fibers and Nutraceuticals in Prevention of Hypertension Research Anthology on Recent Advancements in Ethnopharmacology and Nutraceuticals, 10.4018/978-1-6684-3546-5.ch040, (778-809) Barton T, Low D, Bakker E, Janssen T, de Groot S, van der Woude L and Thijssen D (2021) Traditional Cardiovascular Risk Factors Strongly Underestimate the 5-Year Occurrence of Cardiovascular Morbidity and Mortality in Spinal Cord Injured Individuals, Archives of Physical Medicine and Rehabilitation, 10.1016/j.apmr.2020.07.013, 102:1, (27-34), Online publication date: 1-Jan-2021. Sadat Halder M and Kumar De S (2021) A RETROSPECTIVE COHORT STUDY TO UNDERSTAND THE AGE, GENDER AND RISK FACTORS PATTERN IN PATIENTS ATTENDING FOR CARDIAC REHABILITATION (CR) AFTER CORONARY ARTERY BYPASS GRAFTING (CABG) SURGERY, INDIAN JOURNAL OF APPLIED RESEARCH, 10.36106/ijar/5702089, (57-60), Online publication date: 1-Jul-2021. 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Okami Y, Ueshima H, Nakamura Y, Kondo K, Kadota A, Okuda N, Ohkubo T, Miyamatsu N, Okamura T, Miura K and Okayama A (2021) Risk Factors That Most Accurately Predict Coronary Artery Disease Based on the Duration of Follow-up ― NIPPON DATA80 ―, Circulation Journal, 10.1253/circj.CJ-20-0739, 85:6, (908-913), Online publication date: 25-May-2021. Wilson R, Aminian A and Tahrani A (2021) Metabolic surgery: A clinical update, Diabetes, Obesity and Metabolism, 10.1111/dom.14235, 23:S1, (63-83), Online publication date: 1-Feb-2021. Steger A, Dommasch M, Müller A, Sinnecker D, Huster K, Gotzler T, Gotzler O, Hapfelmeier A, Ulm K, Barthel P, Hnatkova K, Laugwitz K, Malik M and Schmidt G (2020) Polyscore of autonomic parameters for risk stratification of the elderly general population: the Polyscore study, EP Europace, 10.1093/europace/euaa359, 23:5, (789-796), Online publication date: 21-May-2021. Li Y, Sperrin M, Ashcroft D and van Staa T (2021) Consistency of ranking was evaluated as new measure for prediction model stability: longitudinal cohort study, Journal of Clinical Epidemiology, 10.1016/j.jclinepi.2021.06.026, 138, (168-177), Online publication date: 1-Oct-2021. Albaugh V, Kindel T, Nissen S and Aminian A (2021) Cardiovascular Risk Reduction Following Metabolic and Bariatric Surgery, Surgical Clinics of North America, 10.1016/j.suc.2020.12.012, 101:2, (269-294), Online publication date: 1-Apr-2021. Eftychidis I, Sakellari I, Anagnostopoulos A and Gavriilaki E (2021) Endothelial dysfunction and vascular complications after allogeneic hematopoietic cell transplantation: an expert analysis, Expert Review of Hematology, 10.1080/17474086.2021.1968823, 14:9, (831-840), Online publication date: 2-Sep-2021. Vaes B, Indestege P, Serneels T, Hegendörfer E, van Peet P, Poortvliet R, Wallemacq P, Gussekloo J and Degryse J (2020) Biomarkers versus traditional risk factors to predict cardiovascular events in very old adults: cross-validated prospective cohort study, BMJ Open, 10.1136/bmjopen-2019-035809, 10:6, (e035809), Online publication date: 1-Jun-2020. Wong N (2020) Cardiovascular risk assessment: The foundation of preventive cardiology, American Journal of Preventive Cardiology, 10.1016/j.ajpc.2020.100008, 1, (100008), Online publication date: 1-Mar-2020. Anžič Drofenik A, Vrtovec M, Božič Mijovski M, Sever M, Preložnik Zupan I, Kejžar N and Blinc A (2020) Progression of coronary calcium burden and carotid stiffness in patients with essential thrombocythemia associated with JAK2 V617F mutation, Atherosclerosis, 10.1016/j.atherosclerosis.2020.01.001, 296, (25-31), Online publication date: 1-Mar-2020. van Bussel E, Hoevenaar-Blom M, Poortvliet R, Gussekloo J, van Dalen J, van Gool W, Richard E and Moll van Charante E (2020) Predictive value of traditional risk factors for cardiovascular disease in older people: A systematic review, Preventive Medicine, 10.1016/j.ypmed.2020.105986, 132, (105986), Online publication date: 1-Mar-2020. Kim Y, Noh K, Byun S, Lee S, Kim T, Sunwoo L, Lee K, Kang S, Park K and Park S (2020) Effects of Hypertension, Diabetes, and Smoking on Age and Sex Prediction from Retinal Fundus Images, Scientific Reports, 10.1038/s41598-020-61519-9, 10:1, Online publication date: 1-Dec-2020. Palazón-Bru A, Ferri-Rufete D, Mares-García E, Durazo-Arvizu R, Divisón-Garrote J, Carbayo-Herencia J, Artigao-Rodenas L, Simarro-Rueda M, Molina-Escribano F, Ponce-García I, Gil-Guillén V and Pérez-Sempere Á (2020) Clusters of Cardiovascular Risk Factors and Their Impact on the 20-Year Cardiovascular Risk in a General Population, Journal of Cardiovascular Nursing, 10.1097/JCN.0000000000000637, 35:2, (210-216), Online publication date: 1-Mar-2020. Jamthikar A, Gupta D, Saba L, Khanna N, Viskovic K, Mavrogeni S, Laird J, Sattar N, Johri A, Pareek G, Miner M, Sfikakis P, Protogerou A, Viswanathan V, Sharma A, Kitas G, Nicolaides A, Kolluri R and Suri J (2020) Artificial intelligence framework for predictive cardiovascular and stroke risk assessment models: A narrative review of integrated approaches using carotid ultrasound, Computers in Biology and Medicine, 10.1016/j.compbiomed.2020.104043, 126, (104043), Online publication date: 1-Nov-2020. 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Vuksan V, Sievenpiper J, Jovanovski E, Jenkins A, Komishon A, Au-Yeung F, Zurbau A, Ho H, Li D and Smircic-Duvnjak L (2020) Effect of soluble-viscous dietary fibre on coronary heart disease risk score across 3 population health categories: data from randomized, double-blind, placebo-controlled trials, Applied Physiology, Nutrition, and Metabolism, 10.1139/apnm-2019-0728, 45:7, (801-804), Online publication date: 1-Jul-2020. Warner E, Nannarone M, Smail-Crevier R, Manuel D, Lashewicz B, Patten S, Schmitz N, MacQueen G and Wang J (2020) The relationship between depression risk perception and self-help behaviours in high risk Canadians: a cross-sectional study, BMC Public Health, 10.1186/s12889-020-08983-0, 20:1, Online publication date: 1-Dec-2020. Wallisch C, Heinze G, Rinner C, Mundigler G, Winkelmayer W and Dunkler D (2020) Re-estimation improved the performance of two Framingham cardiovascular risk equations and the Pooled Cohort equations: A nationwide registry analysis, Scientific Reports, 10.1038/s41598-020-64629-6, 10:1, Online publication date: 1-Dec-2020. Kim J, Yu M, Kim Y, Min S, Ha J, Lee J, Kim D, Oh K, Joo K, Ahn C, Kim Y and Lee H (2019) Ratio of triglyceride to high-density lipoprotein cholesterol and risk of major cardiovascular events in kidney transplant recipients, Clinical and Experimental Nephrology, 10.1007/s10157-019-01776-9, 23:12, (1407-1417), Online publication date: 1-Dec-2019. Gomez-Sanchez L, Gomez-Marcos M, Patino-Alonso M, Recio-Rodriguez J, Gomez-Sanchez M, González-Sánchez J, Alonso-Domínguez R, Sánchez-Aguadero N, Maderuelo-Fernandez J, Ramos R, Garcia-Ortiz L and Rodriguez-Sanchez E (2019) Reclassification by applying the Framingham equation 30 years to subjects with intermediate cardiovascular risk. MARK study, Medicina Clínica (English Edition), 10.1016/j.medcle.2019.01.035, 153:9, (351-356), Online publication date: 1-Nov-2019. Lee K, Yong H, Lee J, Kang E and Na J (2018) Is the epicardial adipose tissue area on non-ECG gated low-dose chest CT useful for predicting coronary atherosclerosis in an asymptomatic population considered for lung cancer screening?, European Radiology, 10.1007/s00330-018-5562-4, 29:2, (932-940), Online publication date: 1-Feb-2019. Gibson C, Kerneis M, Yee M, Daaboul Y, Korjian S, Mehr A, Tricoci P, Alexander J, Kastelein J, Mehran R, Bode C, Lewis B, Mehta R, Duffy D, Feaster J, Halabi M, Angiolillo D, Duerschmied D, Ophuis T and Merkely B (2019) The CSL112-2001 trial: Safety and tolerability of multiple doses of CSL112 (apolipoprotein A-I [human]), an intravenous formulation of plasma-derived apolipoprotein A-I, among subjects with moderate renal impairment after acute myocardial infarction, American Heart Journal, 10.1016/j.ahj.2018.11.008, 208, (81-90), Online publication date: 1-Feb-2019. ter Wee M and Lissenberg-Witte B (2019) To Predict or not to Predict? A Quick Guide on How to Conduct Medical Research, 10.1007/978-90-368-2248-0_7, (189-227), . Wang J, MacQueen G, Patten S, Manuel D, Lashewicz B and Schmitz N (2019) A randomized controlled trial to examine the impacts of disclosing personalized depression risk information on the outcomes of individuals who are at high risk of developing major depression: a research protocol, BMC Psychiatry, 10.1186/s12888-019-2270-9, 19:1, Online publication date: 1-Dec-2019. Gavriilaki E, Gkaliagkousi E, Sakellari I, Anyfanti P, Douma S and Anagnostopoulos A (2019) Early Prediction of Cardiovascular Risk after Hematopoietic Cell Transplantation: Are We There Yet?, Biology of Blood and Marrow Transplantation, 10.1016/j.bbmt.2019.07.012, 25:10, (e310-e316), Online publication date: 1-Oct-2019. Sarfo F, Nichols M, Gebregziabher M, Tagge R, Asibey S, Jenkins C and Ovbiagele B (2019) Evaluation of Vascular Event Risk while on Long-term Anti-retroviral Suppressive Therapy [EVERLAST]: Protocol for a prospective observational study, eNeurologicalSci, 10.1016/j.ensci.2019.100189, 15, (100189), Online publication date: 1-Jun-2019. van Bronswijk S, Lemmens L, Keefe J, Huibers M, DeRubeis R and Peeters F (2018) A prognostic index for long-term outcome after successful acute phase cognitive therapy and interpersonal psychotherapy for major depressive disorder, Depression and Anxiety, 10.1002/da.22868, 36:3, (252-261), Online publication date: 1-Mar-2019. Dimberg L, Eriksson B and Hashem M (2019) Myocardial infarction and death findings from a 22-year follow-up of a cohort of 980 employed Swedish men, Public Health, 10.1016/j.puhe.2019.07.006, 175, (148-155), Online publication date: 1-Oct-2019. Cifkova R (2019) Arterial Hypertension and Cardiovascular Risk Management of Hypertension, 10.1007/978-3-319-92946-0_3, (57-74), . Rojas C, Ramírez H, Salazar L, Kalergis A, Gálvez A and Escobar‐Vera J (2019) Characterization of LDLR rs5925 and PCSK9 rs505151 genetic variants frequencies in healthy subjects from northern Chile: Influence on plasma lipid levels , Journal of Clinical Laboratory Analysis, 10.1002/jcla.23001, 33:9, Online publication date: 1-Nov-2019. Kotalik A, Eaton A, Lian Q, Serrano C, Connett J and Neaton J (2019) A win ratio approach to the re-analysis of Multiple Risk Factor Intervention Trial, Clinical Trials, 10.1177/1740774519868233, 16:6, (626-634), Online publication date: 1-Dec-2019. An Y, Yun S, Yang I, Kim D and Yang D (2019) Predictive Performance of Ultrasound-Determined Non-Alcoholic Fatty Pancreas Disease Severity for Intermediate and High Risk of Coronary Heart Disease, Journal of the Korean Society of Radiology, 10.3348/jksr.2019.80.6.1190, 80:6, (1190), . Sakaki J, Melough M, Lee S, Pounis G and Chun O (2019) Polyphenol-Rich Diets in Cardiovascular Disease Prevention Analysis in Nutrition Research, 10.1016/B978-0-12-814556-2.00010-5, (259-298), . Gomez-Sanchez L, Gomez-Marcos M, Patino-Alonso M, Recio-Rodriguez J, Gomez-Sanchez M, González-Sánchez J, Alonso-Domínguez R, Sánchez-Aguadero N, Maderuelo-Fernandez J, Ramos R, Garcia-Ortiz L and Rodriguez-Sanchez E (2019) Reclassification by applying the Framingham equation 30 years to subjects with intermediate cardiovascular risk. MARK study, Medicina Clínica, 10.1016/j.medcli.2019.01.033, 153:9, (351-356), Online publication date: 1-Nov-2019. Chen G, Gao L and Li X (2019) Effects of exercise training on cardiovascular risk factors in kidney transplant recipients: a systematic review and meta-analysis, Renal Failure, 10.1080/0886022X.2019.1611602, 41:1, (408-418), Online publication date: 1-Jan-2019. Rosenblit P (2019) Extreme Atherosclerotic Cardiovascular Disease (ASCVD) Risk Recognition, Current Diabetes Reports, 10.1007/s11892-019-1178-6, 19:8, Online publication date: 1-Aug-2019. Disouza J, Patil K, Kakade P and Patravale V (2019) Dietary Fibers and Nutraceuticals in Prevention of Hypertension Nutraceutical and Functional Foods in Disease Prevention, 10.4018/978-1-5225-3267-5.ch007, (192-232) Charles‐Schoeman C, DeMasi R, Valdez H, Soma K, Hwang L, Boy M, Biswas P and McInnes I (2019) Risk Factors for Major Adverse Cardiovascular Events in Phase III and Long‐Term Extension Studies of Tofacitinib in Patients With Rheumatoid Arthritis , Arthritis & Rheumatology, 10.1002/art.40911, 71:9, (1450-1459), Online publication date: 1-Sep-2019. Sánchez-Acevedo M, Acosta-Chí Z, Sabino-Moxo B, Márquez-Domínguez J and Canton-Croda R (2019) Big Data Analysis for Cardiovascular Diseases Coronary and Cardiothoracic Critical Care, 10.4018/978-1-5225-8185-7.ch004, (60-77) Plante T, Juraschek S, Zakai N, Tracy R and Cushman M (2019) Comparison of Frequency of Atherosclerotic Cardiovascular Disease Events Among Primary and Secondary Prevention Subgroups of the Systolic Blood Pressure Intervention Trial, The American Journal of Cardiology, 10.1016/j.amjcard.2019.08.028, 124:11, (1701-1706), Online publication date: 1-Dec-2019. Nakas G, Bechlioulis A, Marini A, Vakalis K, Bougiakli M, Giannitsi S, Nikolaou K, Antoniadou E, Kotsia A, Gartzonika K, Chasiotis G, Bairaktari E, Katsouras C, Triantis G, Sionis D, Michalis L and Naka K (2019) The importance of characteristics of angina symptoms for the prediction of coronary artery disease in a cohort of stable patients in the modern era, Hellenic Journal of Cardiology, 10.1016/j.hjc.2018.06.003, 60:4, (241-246), Online publication date: 1-Jul-2019. Buettner R and Schunter M (2019) Efficient machine learning based detection of heart disease 2019 IEEE International Conference on E-health Networking, Application & Services (HealthCom), 10.1109/HealthCom46333.2019.9009429, 978-1-7281-0402-7, (1-6) Albarqouni L, Doust J, Magliano D, Barr E, Shaw J and Glasziou P (2019) External validation and comparison of four cardiovascular risk prediction models with data from the Australian Diabetes, Obesity and Lifestyle study, Medical Journal of Australia, 10.5694/mja2.12061, 210:4, (161-167), Online publication date: 1-Mar-2019. Liu Y, Li Q, Chen S, Wang X, Zhou Y, Tan N and Chen J (2018) A Simple Modified Framingham Scoring System to Predict Obstructive Coronary Artery Disease, Journal of Cardiovascular Translational Research, 10.1007/s12265-018-9837-6, 11:6, (495-502), Online publication date: 1-Dec-2018. Hermansson J and Kahan T (2017) Systematic Review of Validity Assessments of Framingham Risk Score Results in Health of Therapies in Online publication date: M, V, J, E, C, G, L and A (2018) levels in and as markers of and adipose tissue BMC Online publication date: 1-Dec-2018. H, T, D and E (2018) Risk Factors for Heart Disease International on Medical and (1-6) J, B, Wang J, S, S, C, S, C and MacQueen G (2018) for of the study, BMC Psychiatry, Online publication date: 1-Dec-2018. 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Cardiology and Cardiovascular Medicine Radiology, Nuclear Medicine and Imaging Public Health, Environmental and Occupational Health

The International Glossary on Infertility and Fertility Care, 2017

Fertility and Sterility2017-07-29作者：Fernando Zegers-Hochschild, G. David Adamson, Silke Dyer

STUDY QUESTION: What updates of the International Glossary on Infertility and Fertility Care are required, to reflect contemporary scientific knowledge, social needs, and inclusive definitions, while harmonizing international communication across clinical, research, policy, and public domains? SUMMARY ANSWER: This 4th edition presents 348 consensus-based terms and definitions, including numerous revisions from the previous edition and 79 newly introduced definitions reflecting advances in reproductive science, technology, and evolving social contexts. WHAT IS KNOWN ALREADY: Previous glossary editions (2006, 2009, 2017) established internationally recognized definitions related to clinical practice, research, and policy. The 2017 edition comprised 283 terms and, among many others, expanded the concept of infertility to include not only its recognition as a disease, but also as an impairment of function generating disability. The glossary has been extensively used worldwide and has contributed to international standardization of data collection, appropriate comparison of outcome measures, and provided a reference for all stakeholders including policy makers. STUDY DESIGN, SIZE, DURATION: Under guidance of the organizing committee, 21 professionals from across the world, and representing expertise in different sub-specialties, formed five working groups: clinical definitions; outcome measures; embryology laboratory; clinical and laboratory andrology; and epidemiology, public health and gender related definitions. The definitions from the previous glossary were evaluated and new terms identified. All definitions were then reviewed by an international advisory panel of nine experts that evaluated the glossary from scientific, ethical, cultural, and policy perspectives. PARTICIPANTS/MATERIALS, SETTING, METHODS: Between November 2024 and October 2025, periodical virtual meetings were held within and between working groups and the organizing committee. Following circulation of the first consensually agreed draft, a one-day in-person meeting with representatives of all working groups and members of the international advisory panel was held at ESHRE, June 2025. Most terms and definitions were discussed and agreed. In the absence of agreement, further discussions were held between the organizing committee, working group chairs and members of the advisory panel. It had been determined at the outset that final disagreement would be resolved via a two-third majority vote. All terms and definitions were, however, reached by consensus and adopted following a final round of review and approval by all authors. MAIN RESULTS AND THE ROLE OF CHANCE: The glossary now includes 348 terms. Compared to the previous edition, 14 terms were deleted, numerous terms modified and 79 new terms were added. Modifications reflect current scientific knowledge, technological advancements, and inclusivity related to gender and family structures. Chance does not play a role, as all definitions are consensus-based. LIMITATIONS, REASONS FOR CAUTION: Some terms may require future refinement as scientific knowledge evolves and societal contexts change. The glossary reflects consensus rather than empirical testing of all definitions. WIDER IMPLICATIONS OF THE FINDINGS: This glossary provides a global reference for standardized terminology, supporting clinical care, research, international comparisons, policy making, patient communication, and reproductive health literacy. STUDY FUNDING/COMPETING INTEREST(S): Neither ICMART, responsible for conducting this project, nor any of the participants received specific financial support for their activities in this project. Ferring provided ICMART with a fixed amount to cover venue costs and a one-day hotel accommodation for participants attending the in-person meeting held prior to the ESHRE Congress in June 2025. Disclosures were provided by all authors, and none reported any conflict of interest related to this manuscript. TRIAL REGISTRATION NUMBER: N/A.

Reproductive Medicine Reproductive Medicine Reproductive Medicine

Review of guidelines for good practice in decision-analytic modelling in health technology assessment

Health Technology Assessment2004-09-01作者：Z Philips, Laura Ginnelly, Mark Sculpher

OBJECTIVES: To identify existing guidelines and develop a synthesised guideline plus accompanying checklist. In addition to provide guidance on key theoretical, methodological and practical issues and consider the implications of this research for what might be expected of future decision-analytic models. DATA SOURCES: Electronic databases. REVIEW METHODS: A systematic review of existing good practice guidelines was undertaken to identify and summarise guidelines currently available for assessing the quality of decision-analytic models that have been undertaken for health technology assessment. A synthesised good practice guidance and accompanying checklist was developed. Two specific methods areas in decision modelling were considered. The first method's topic is the identification of parameter estimates from published literature. Parameter searches were developed and piloted using a case-study model. The second topic relates to bias in parameter estimates; that is, how to adjust estimates of treatment effect from observational studies where there are risks of selection bias. A systematic literature review was conducted to identify those studies looking at quantification of bias in parameter estimates and the implication of this bias. RESULTS: Fifteen studies met the inclusion criteria and were reviewed and consolidated into a single set of brief statements of good practice. From this, a checklist was developed and applied to three independent decision-analytic models. Although the checklist provided excellent guidance on some key issues for model evaluation, it was too general to pick up on the specific nuances of each model. The searches that were developed helped to identify important data for inclusion in the model. However, the quality of life searches proved to be problematic: the published search filters did not focus on those measures specific to cost-effectiveness analysis and although the strategies developed as part of this project were more successful few data were found. Of the 11 studies meeting the criteria on the effect of selection bias, five concluded that a non-randomised trial design is associated with bias and six studies found 'similar' estimates of treatment effects from observational studies or non-randomised clinical trials and randomised controlled trials (RCTs). One purpose of developing the synthesised guideline and checklist was to provide a framework for critical appraisal by the various parties involved in the health technology assessment process. First, the guideline and checklist can be used by groups that are reviewing other analysts' models and, secondly, the guideline and checklist could be used by the various analysts as they develop their models (to use it as a check on how they are developing and reporting their analyses). The Expert Advisory Group (EAG) that was convened to discuss the potential role of the guidance and checklist felt that, in general, the guidance and checklist would be a useful tool, although the checklist is not meant to be used exclusively to determine a model's quality, and so should not be used as a substitute for critical appraisal. CONCLUSIONS: The review of current guidelines showed that although authors may provide a consistent message regarding some aspects of modelling, in other areas conflicting attributes are presented in different guidelines. In general, the checklist appears to perform well, in terms of identifying those aspects of the model that should be of particular concern to the reader. The checklist cannot, however, provide answers to the appropriateness of the model structure and structural assumptions, as these may be seen as a general problem with generic checklists and do not reflect any shortcoming with the synthesised guidance and checklist developed here. The assessment of the checklist, as well as feedback from the EAG, indicated the importance of its use in conjunction with a more general checklist or guidelines on economic evaluation. Further methods research into the following areas would be valuable: the quantification of selection bias in non-controlled studies and in controlled observational studies; the level of bias in the different non-RCT study designs; a comparison of results from RCTs with those from other non-randomised studies; assessment of the strengths and weaknesses of alternative ways to adjust for bias in a decision model; and how to prioritise searching for parameter estimates.

Economics and Econometrics Aging Economics and Econometrics

Continuing education meetings and workshops: effects on professional practice and health care outcomes

Cochrane Database of Systematic Reviews2009-04-15作者：Louise Forsetlund, Arild Bjørndal, Arash Rashidian

BACKGROUND: Educational meetings are widely used for continuing medical education. Previous reviews found that interactive workshops resulted in moderately large improvements in professional practice, whereas didactic sessions did not. OBJECTIVES: To assess the effects of educational meetings on professional practice and healthcare outcomes. SEARCH STRATEGY: We updated previous searches by searching the Cochrane Effective Practice and Organisation of Care Group Trials Register and pending file, from 1999 to March 2006. SELECTION CRITERIA: Randomised controlled trials of educational meetings that reported an objective measure of professional practice or healthcare outcomes. DATA COLLECTION AND ANALYSIS: Two authors independently extracted data and assessed study quality. Studies with a low or moderate risk of bias and that reported baseline data were included in the primary analysis. They were weighted according to the number of health professionals participating. For each comparison, we calculated the risk difference (RD) for dichotomous outcomes, adjusted for baseline compliance; and for continuous outcomes the percentage change relative to the control group average after the intervention, adjusted for baseline performance. Professional and patient outcomes were analysed separately. We considered 10 factors to explain heterogeneity of effect estimates using weighted meta-regression supplemented by visual analysis of bubble and box plots. MAIN RESULTS: In updating the review, 49 new studies were identified for inclusion. A total of 81 trials involving more than 11,000 health professionals are now included in the review. Based on 30 trials (36 comparisons), the median adjusted RD in compliance with desired practice was 6% (interquartile range 1.8 to 15.9) when any intervention in which educational meetings were a component was compared to no intervention. Educational meetings alone had similar effects (median adjusted RD 6%, interquartile range 2.9 to 15.3; based on 21 comparisons in 19 trials). For continuous outcomes the median adjusted percentage change relative to control was 10% (interquartile range 8 to 32%; 5 trials). For patient outcomes the median adjusted RD in achievement of treatment goals was 3.0 (interquartile range 0.1 to 4.0; 5 trials). Based on univariate meta-regression analyses of the 36 comparisons with dichotomous outcomes for professional practice, higher attendance at the educational meetings was associated with larger adjusted RDs (P < 0.01); mixed interactive and didactic education meetings (median adjusted RD 13.6) were more effective than either didactic meetings (RD 6.9) or interactive meetings (RD 3.0). Educational meetings did not appear to be effective for complex behaviours (adjusted RD -0.3) compared to less complex behaviours; they appeared to be less effective for less serious outcomes (RD 2.9) than for more serious outcomes. AUTHORS' CONCLUSIONS: Educational meetings alone or combined with other interventions, can improve professional practice and healthcare outcomes for the patients. The effect is most likely to be small and similar to other types of continuing medical education, such as audit and feedback, and educational outreach visits. Strategies to increase attendance at educational meetings, using mixed interactive and didactic formats, and focusing on outcomes that are likely to be perceived as serious may increase the effectiveness of educational meetings. Educational meetings alone are not likely to be effective for changing complex behaviours.

Public Health, Environmental and Occupational Health Sociology and Political Science Family Practice

Developing and Evaluating Digital Interventions to Promote Behavior Change in Health and Health Care: Recommendations Resulting From an International Workshop

Journal of Medical Internet Research2017-06-29作者：Susan Michie, Lucy Yardley, Robert West

Devices and programs using digital technology to foster or support behavior change (digital interventions) are increasingly ubiquitous, being adopted for use in patient diagnosis and treatment, self-management of chronic diseases, and in primary prevention. They have been heralded as potentially revolutionizing the ways in which individuals can monitor and improve their health behaviors and health care by improving outcomes, reducing costs, and improving the patient experience. However, we are still mainly in the age of promise rather than delivery. Developing and evaluating these digital interventions presents new challenges and new versions of old challenges that require use of improved and perhaps entirely new methods for research and evaluation. This article discusses these challenges and provides recommendations aimed at accelerating the rate of progress in digital behavior intervention research and practice. Areas addressed include intervention development in a rapidly changing technological landscape, promoting user engagement, advancing the underpinning science and theory, evaluating effectiveness and cost-effectiveness, and addressing issues of regulatory, ethical, and information governance. This article is the result of a two-day international workshop on how to create, evaluate, and implement effective digital interventions in relation to health behaviors. It was held in London in September 2015 and was supported by the United Kingdom's Medical Research Council (MRC), the National Institute for Health Research (NIHR), the Methodology Research Programme (PI Susan Michie), and the Robert Wood Johnson Foundation of the United States (PI Kevin Patrick). Important recommendations to manage the rapid pace of change include considering using emerging techniques from data science, machine learning, and Bayesian approaches and learning from other disciplines including computer science and engineering. With regard to assessing and promoting engagement, a key conclusion was that sustained engagement is not always required and that for each intervention it is useful to establish what constitutes "effective engagement," that is, sufficient engagement to achieve the intended outcomes. The potential of digital interventions for testing and advancing theories of behavior change by generating ecologically valid, real-time objective data was recognized. Evaluations should include all phases of the development cycle, designed for generalizability, and consider new experimental designs to make the best use of rich data streams. Future health economics analyses need to recognize and model the complex and potentially far-reaching costs and benefits of digital interventions. In terms of governance, developers of digital behavior interventions should comply with existing regulatory frameworks, but with consideration for emerging standards around information governance, ethics, and interoperability.

Applied Psychology General Health Professions Education

Beyond Adoption: A New Framework for Theorizing and Evaluating Nonadoption, Abandonment, and Challenges to the Scale-Up, Spread, and Sustainability of Health and Care Technologies

Journal of Medical Internet Research2017-11-01作者：Trisha Greenhalgh, Joseph Wherton, Chrysanthi Papoutsi

BACKGROUND: Many promising technological innovations in health and social care are characterized by nonadoption or abandonment by individuals or by failed attempts to scale up locally, spread distantly, or sustain the innovation long term at the organization or system level. OBJECTIVE: Our objective was to produce an evidence-based, theory-informed, and pragmatic framework to help predict and evaluate the success of a technology-supported health or social care program. METHODS: The study had 2 parallel components: (1) secondary research (hermeneutic systematic review) to identify key domains, and (2) empirical case studies of technology implementation to explore, test, and refine these domains. We studied 6 technology-supported programs-video outpatient consultations, global positioning system tracking for cognitive impairment, pendant alarm services, remote biomarker monitoring for heart failure, care organizing software, and integrated case management via data sharing-using longitudinal ethnography and action research for up to 3 years across more than 20 organizations. Data were collected at micro level (individual technology users), meso level (organizational processes and systems), and macro level (national policy and wider context). Analysis and synthesis was aided by sociotechnically informed theories of individual, organizational, and system change. The draft framework was shared with colleagues who were introducing or evaluating other technology-supported health or care programs and refined in response to feedback. RESULTS: The literature review identified 28 previous technology implementation frameworks, of which 14 had taken a dynamic systems approach (including 2 integrative reviews of previous work). Our empirical dataset consisted of over 400 hours of ethnographic observation, 165 semistructured interviews, and 200 documents. The final nonadoption, abandonment, scale-up, spread, and sustainability (NASSS) framework included questions in 7 domains: the condition or illness, the technology, the value proposition, the adopter system (comprising professional staff, patient, and lay caregivers), the organization(s), the wider (institutional and societal) context, and the interaction and mutual adaptation between all these domains over time. Our empirical case studies raised a variety of challenges across all 7 domains, each classified as simple (straightforward, predictable, few components), complicated (multiple interacting components or issues), or complex (dynamic, unpredictable, not easily disaggregated into constituent components). Programs characterized by complicatedness proved difficult but not impossible to implement. Those characterized by complexity in multiple NASSS domains rarely, if ever, became mainstreamed. The framework showed promise when applied (both prospectively and retrospectively) to other programs. CONCLUSIONS: Subject to further empirical testing, NASSS could be applied across a range of technological innovations in health and social care. It has several potential uses: (1) to inform the design of a new technology; (2) to identify technological solutions that (perhaps despite policy or industry enthusiasm) have a limited chance of achieving large-scale, sustained adoption; (3) to plan the implementation, scale-up, or rollout of a technology program; and (4) to explain and learn from program failures.

Public Health, Environmental and Occupational Health Health Information Management General Health Professions

Local opinion leaders: effects on professional practice and health care outcomes

Cochrane Database of Systematic Reviews2011-08-04作者：Gerd Flodgren, Elena Parmelli, Gaby Doumit

BACKGROUND: Clinical practice is not always evidence-based and, therefore, may not optimise patient outcomes. Opinion leaders disseminating and implementing 'best evidence' is one method that holds promise as a strategy to bridge evidence-practice gaps. OBJECTIVES: To assess the effectiveness of the use of local opinion leaders in improving professional practice and patient outcomes. SEARCH STRATEGY: We searched Cochrane EPOC Group Trials Register, the Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, HMIC, Science Citation Index, Social Science Citation Index, ISI Conference Proceedings and World Cat Dissertations up to 5 May 2009. In addition, we searched reference lists of included articles. SELECTION CRITERIA: Studies eligible for inclusion were randomised controlled trials investigating the effectiveness of using opinion leaders to disseminate evidence-based practice and reporting objective measures of professional performance and/or health outcomes. DATA COLLECTION AND ANALYSIS: Two review authors independently extracted data from each study and assessed its risk of bias. For each trial, we calculated the median risk difference (RD) for compliance with desired practice, adjusting for baseline where data were available. We reported the median adjusted RD for each of the main comparisons. MAIN RESULTS: We included 18 studies involving more than 296 hospitals and 318 PCPs. Fifteen studies (18 comparisons) contributed to the calculations of the median adjusted RD for the main comparisons. The effects of interventions varied across the 63 outcomes from 15% decrease in compliance to 72% increase in compliance with desired practice. The median adjusted RD for the main comparisons were: i) Opinion leaders compared to no intervention, +0.09; ii) Opinion leaders alone compared to a single intervention, +0.14; iii) Opinion leaders with one or more additional intervention(s) compared to the one or more additional intervention(s), +0.10; iv) Opinion leaders as part of multiple interventions compared to no intervention, +0.10. Overall, across all 18 studies the median adjusted RD was +0.12 representing a 12% absolute increase in compliance in the intervention group. AUTHORS' CONCLUSIONS: Opinion leaders alone or in combination with other interventions may successfully promote evidence-based practice, but effectiveness varies both within and between studies. These results are based on heterogeneous studies differing in terms of type of intervention, setting, and outcomes measured. In most of the studies the role of the opinion leader was not clearly described, and it is therefore not possible to say what the best way is to optimise the effectiveness of opinion leaders.

General Health Professions General Health Professions General Health Professions

Wearable Health Devices in Health Care: Narrative Systematic Review

JMIR mhealth and uhealth2020-09-24作者：Lin Lu, Jiayao Zhang, Yi Xie

BACKGROUND: With the rise of mobile medicine, the development of new technologies such as smart sensing, and the popularization of personalized health concepts, the field of smart wearable devices has developed rapidly in recent years. Among them, medical wearable devices have become one of the most promising fields. These intelligent devices not only assist people in pursuing a healthier lifestyle but also provide a constant stream of health care data for disease diagnosis and treatment by actively recording physiological parameters and tracking metabolic status. Therefore, wearable medical devices have the potential to become a mainstay of the future mobile medical market. OBJECTIVE: Although previous reviews have discussed consumer trends in wearable electronics and the application of wearable technology in recreational and sporting activities, data on broad clinical usefulness are lacking. We aimed to review the current application of wearable devices in health care while highlighting shortcomings for further research. In addition to daily health and safety monitoring, the focus of our work was mainly on the use of wearable devices in clinical practice. METHODS: We conducted a narrative review of the use of wearable devices in health care settings by searching papers in PubMed, EMBASE, Scopus, and the Cochrane Library published since October 2015. Potentially relevant papers were then compared to determine their relevance and reviewed independently for inclusion. RESULTS: A total of 82 relevant papers drawn from 960 papers on the subject of wearable devices in health care settings were qualitatively analyzed, and the information was synthesized. Our review shows that the wearable medical devices developed so far have been designed for use on all parts of the human body, including the head, limbs, and torso. These devices can be classified into 4 application areas: (1) health and safety monitoring, (2) chronic disease management, (3) disease diagnosis and treatment, and (4) rehabilitation. However, the wearable medical device industry currently faces several important limitations that prevent further use of wearable technology in medical practice, such as difficulties in achieving user-friendly solutions, security and privacy concerns, the lack of industry standards, and various technical bottlenecks. CONCLUSIONS: We predict that with the development of science and technology and the popularization of personalized health concepts, wearable devices will play a greater role in the field of health care and become better integrated into people's daily lives. However, more research is needed to explore further applications of wearable devices in the medical field. We hope that this review can provide a useful reference for the development of wearable medical devices.

Biomedical Engineering General Health Professions Computer Vision and Pattern Recognition

The future of mental health care: peer-to-peer support and social media

Epidemiology and Psychiatric Sciences2016-01-08作者：John A. Naslund, Kelly A. Aschbrenner, Lisa A. Marsch

AIMS: People with serious mental illness are increasingly turning to popular social media, including Facebook, Twitter or YouTube, to share their illness experiences or seek advice from others with similar health conditions. This emerging form of unsolicited communication among self-forming online communities of patients and individuals with diverse health concerns is referred to as peer-to-peer support. We offer a perspective on how online peer-to-peer connections among people with serious mental illness could advance efforts to promote mental and physical wellbeing in this group. METHODS: In this commentary, we take the perspective that when an individual with serious mental illness decides to connect with similar others online it represents a critical point in their illness experience. We propose a conceptual model to illustrate how online peer-to-peer connections may afford opportunities for individuals with serious mental illness to challenge stigma, increase consumer activation and access online interventions for mental and physical wellbeing. RESULTS: People with serious mental illness report benefits from interacting with peers online from greater social connectedness, feelings of group belonging and by sharing personal stories and strategies for coping with day-to-day challenges of living with a mental illness. Within online communities, individuals with serious mental illness could challenge stigma through personal empowerment and providing hope. By learning from peers online, these individuals may gain insight about important health care decisions, which could promote mental health care seeking behaviours. These individuals could also access interventions for mental and physical wellbeing delivered through social media that could incorporate mutual support between peers, help promote treatment engagement and reach a wider demographic. Unforeseen risks may include exposure to misleading information, facing hostile or derogatory comments from others, or feeling more uncertain about one's health condition. However, given the evidence to date, the benefits of online peer-to-peer support appear to outweigh the potential risks. CONCLUSION: Future research must explore these opportunities to support and empower people with serious mental illness through online peer networks while carefully considering potential risks that may arise from online peer-to-peer interactions. Efforts will also need to address methodological challenges in the form of evaluating interventions delivered through social media and collecting objective mental and physical health outcome measures online. A key challenge will be to determine whether skills learned from peers in online networks translate into tangible and meaningful improvements in recovery, employment, or mental and physical wellbeing in the offline world.

General Health Professions Applied Psychology Health

The Effectiveness of Mobile-Health Technology-Based Health Behaviour Change or Disease Management Interventions for Health Care Consumers: A Systematic Review

PLoS Medicine2013-01-15作者：Caroline Free, Gemma Phillips, Leandro Galli

BACKGROUND: Mobile technologies could be a powerful media for providing individual level support to health care consumers. We conducted a systematic review to assess the effectiveness of mobile technology interventions delivered to health care consumers. METHODS AND FINDINGS: We searched for all controlled trials of mobile technology-based health interventions delivered to health care consumers using MEDLINE, EMBASE, PsycINFO, Global Health, Web of Science, Cochrane Library, UK NHS HTA (Jan 1990-Sept 2010). Two authors extracted data on allocation concealment, allocation sequence, blinding, completeness of follow-up, and measures of effect. We calculated effect estimates and used random effects meta-analysis. We identified 75 trials. Fifty-nine trials investigated the use of mobile technologies to improve disease management and 26 trials investigated their use to change health behaviours. Nearly all trials were conducted in high-income countries. Four trials had a low risk of bias. Two trials of disease management had low risk of bias; in one, antiretroviral (ART) adherence, use of text messages reduced high viral load (>400 copies), with a relative risk (RR) of 0.85 (95% CI 0.72-0.99), but no statistically significant benefit on mortality (RR 0.79 [95% CI 0.47-1.32]). In a second, a PDA based intervention increased scores for perceived self care agency in lung transplant patients. Two trials of health behaviour management had low risk of bias. The pooled effect of text messaging smoking cessation support on biochemically verified smoking cessation was (RR 2.16 [95% CI 1.77-2.62]). Interventions for other conditions showed suggestive benefits in some cases, but the results were not consistent. No evidence of publication bias was demonstrated on visual or statistical examination of the funnel plots for either disease management or health behaviours. To address the limitation of the older search, we also reviewed more recent literature. CONCLUSIONS: Text messaging interventions increased adherence to ART and smoking cessation and should be considered for inclusion in services. Although there is suggestive evidence of benefit in some other areas, high quality adequately powered trials of optimised interventions are required to evaluate effects on objective outcomes.

General Health Professions Applied Psychology Applied Psychology

The effectiveness of M-health technologies for improving health and health services: a systematic review protocol

BMC Research Notes2010-10-06作者：Caroline Free, Gemma Phillips, Lambert Felix

BACKGROUND: The application of mobile computing and communication technology is rapidly expanding in the fields of health care and public health. This systematic review will summarise the evidence for the effectiveness of mobile technology interventions for improving health and health service outcomes (M-health) around the world. FINDINGS: To be included in the review interventions must aim to improve or promote health or health service use and quality, employing any mobile computing and communication technology. This includes: (1) interventions designed to improve diagnosis, investigation, treatment, monitoring and management of disease; (2) interventions to deliver treatment or disease management programmes to patients, health promotion interventions, and interventions designed to improve treatment compliance; and (3) interventions to improve health care processes e.g. appointment attendance, result notification, vaccination reminders.A comprehensive, electronic search strategy will be used to identify controlled studies, published since 1990, and indexed in MEDLINE, EMBASE, PsycINFO, Global Health, Web of Science, the Cochrane Library, or the UK NHS Health Technology Assessment database. The search strategy will include terms (and synonyms) for the following mobile electronic devices (MEDs) and a range of compatible media: mobile phone; personal digital assistant (PDA); handheld computer (e.g. tablet PC); PDA phone (e.g. BlackBerry, Palm Pilot); Smartphone; enterprise digital assistant; portable media player (i.e. MP3 or MP4 player); handheld video game console. No terms for health or health service outcomes will be included, to ensure that all applications of mobile technology in public health and health services are identified. Bibliographies of primary studies and review articles meeting the inclusion criteria will be searched manually to identify further eligible studies. Data on objective and self-reported outcomes and study quality will be independently extracted by two review authors. Where there are sufficient numbers of similar interventions, we will calculate and report pooled risk ratios or standardised mean differences using meta-analysis. DISCUSSION: This systematic review will provide recommendations on the use of mobile computing and communication technology in health care and public health and will guide future work on intervention development and primary research in this field.

General Health Professions Health Information Management Applied Psychology

Artificial Intelligence for Global Health: Learning From a Decade of Digital Transformation in Health Care

arXiv2020-05-20作者：Varoon Mathur, Saptarshi Purkayastha, Judy Wawira Gichoya

The health needs of those living in resource-limited settings are a vastly overlooked and understudied area in the intersection of machine learning (ML) and health care. While the use of ML in health care is more recently popularized over the last few years from the advancement of deep learning, low-and-middle income countries (LMICs) have already been undergoing a digital transformation of their own in health care over the last decade, leapfrogging milestones due to the adoption of mobile health (mHealth). With the introduction of new technologies, it is common to start afresh with a top-down approach, and implement these technologies in isolation, leading to lack of use and a waste of resources. In this paper, we outline the necessary considerations both from the perspective of current gaps in research, as well as from the lived experiences of health care professionals in resource-limited settings. We also outline briefly several key components of successful implementation and deployment of technologies within health systems in LMICs, including technical and cultural considerations in the development process relevant to the building of machine learning solutions. We then draw on

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Are nationally oriented journals indexed in Scopus becoming more international? The effect of publication language and access modality

arXiv2020-02-18作者：Henk F. Moed, Felix de Moya-Anegon, Vicente Guerrero-Bote

An exploratory, descriptive analysis is presented of the national orientation of scientific, scholarly journals as reflected in the affiliations of publishing or citing authors. It calculates for journals covered in Scopus an Index of National Orientation (INO), and analyses the distribution of INO values across disciplines and countries, and the correlation between INO values and journal impact factors. The study did not find solid evidence that journal impact factors are good measures of journal internationality in terms of the geographical distribution of publishing or citing authors, as the relationship between a journal's national orientation and its citation impact is found to be inverse U-shaped. In addition, journals publishing in English are not necessarily internationally oriented in terms of the affiliations of publishing or citing authors; in social sciences and humanities also USA has their nationally oriented literatures. The paper examines the extent to which nationally oriented journals entering Scopus in earlier years, have become in recent years more international. It is found that in the study set about 40 per cent of such journals does reveal traces of internati

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Comparing the Efficacy of GPT-4 and Chat-GPT in Mental Health Care: A Blind Assessment of Large Language Models for Psychological Support

arXiv2024-05-15作者：Birger Moell

Background: Rapid advancements in natural language processing have led to the development of large language models with the potential to revolutionize mental health care. These models have shown promise in assisting clinicians and providing support to individuals experiencing various psychological challenges. Objective: This study aims to compare the performance of two large language models, GPT-4 and Chat-GPT, in responding to a set of 18 psychological prompts, to assess their potential applicability in mental health care settings. Methods: A blind methodology was employed, with a clinical psychologist evaluating the models' responses without knowledge of their origins. The prompts encompassed a diverse range of mental health topics, including depression, anxiety, and trauma, to ensure a comprehensive assessment. Results: The results demonstrated a significant difference in performance between the two models (p > 0.05). GPT-4 achieved an average rating of 8.29 out of 10, while Chat-GPT received an average rating of 6.52. The clinical psychologist's evaluation suggested that GPT-4 was more effective at generating clinically relevant and empathetic responses, thereby providing be

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Fostering implementation of health services research findings into practice: a consolidated framework for advancing implementation science

Implementation Science2009-08-07作者：Laura J. Damschroder, David C. Aron, Rosalind E. Keith

BACKGROUND: Many interventions found to be effective in health services research studies fail to translate into meaningful patient care outcomes across multiple contexts. Health services researchers recognize the need to evaluate not only summative outcomes but also formative outcomes to assess the extent to which implementation is effective in a specific setting, prolongs sustainability, and promotes dissemination into other settings. Many implementation theories have been published to help promote effective implementation. However, they overlap considerably in the constructs included in individual theories, and a comparison of theories reveals that each is missing important constructs included in other theories. In addition, terminology and definitions are not consistent across theories. We describe the Consolidated Framework For Implementation Research (CFIR) that offers an overarching typology to promote implementation theory development and verification about what works where and why across multiple contexts. METHODS: We used a snowball sampling approach to identify published theories that were evaluated to identify constructs based on strength of conceptual or empirical support for influence on implementation, consistency in definitions, alignment with our own findings, and potential for measurement. We combined constructs across published theories that had different labels but were redundant or overlapping in definition, and we parsed apart constructs that conflated underlying concepts. RESULTS: The CFIR is composed of five major domains: intervention characteristics, outer setting, inner setting, characteristics of the individuals involved, and the process of implementation. Eight constructs were identified related to the intervention (e.g., evidence strength and quality), four constructs were identified related to outer setting (e.g., patient needs and resources), 12 constructs were identified related to inner setting (e.g., culture, leadership engagement), five constructs were identified related to individual characteristics, and eight constructs were identified related to process (e.g., plan, evaluate, and reflect). We present explicit definitions for each construct. CONCLUSION: The CFIR provides a pragmatic structure for approaching complex, interacting, multi-level, and transient states of constructs in the real world by embracing, consolidating, and unifying key constructs from published implementation theories. It can be used to guide formative evaluations and build the implementation knowledge base across multiple studies and settings.

General Health Professions General Health Professions Sociology and Political Science

Use of surrogate endpoints in health technology assessment: a review of selected NICE technology appraisals in oncology

arXiv2024-12-03作者：Lorna Wheaton, Sylwia Bujkiewicz

Objectives: Surrogate endpoints, used to substitute for and predict final clinical outcomes, are increasingly being used to support submissions to health technology assessment agencies. The increase in use of surrogate endpoints has been accompanied by literature describing frameworks and statistical methods to ensure their robust validation. The aim of this review was to assess how surrogate endpoints have recently been used in oncology technology appraisals by the National Institute for Health and Care Excellence (NICE) in England and Wales. Methods: This paper identified technology appraisals in oncology published by NICE between February 2022 and May 2023. Data are extracted on methods for the use and validation of surrogate endpoints. Results: Of the 47 technology appraisals in oncology available for review, 18 (38 percent) utilised surrogate endpoints, with 37 separate surrogate endpoints being discussed. However, the evidence supporting the validity of the surrogate relationship varied significantly across putative surrogate relationships with 11 providing RCT evidence, 7 providing evidence from observational studies, 12 based on clinical opinion and 7 providing no evidence

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The Effectiveness of Mobile-Health Technologies to Improve Health Care Service Delivery Processes: A Systematic Review and Meta-Analysis

PLoS Medicine2013-01-15作者：Caroline Free, Gemma Phillips, Louise Watson

BACKGROUND: Mobile health interventions could have beneficial effects on health care delivery processes. We aimed to conduct a systematic review of controlled trials of mobile technology interventions to improve health care delivery processes. METHODS AND FINDINGS: We searched for all controlled trials of mobile technology based health interventions using MEDLINE, EMBASE, PsycINFO, Global Health, Web of Science, Cochrane Library, UK NHS HTA (Jan 1990-Sept 2010). Two authors independently extracted data on allocation concealment, allocation sequence, blinding, completeness of follow-up, and measures of effect. We calculated effect estimates and we used random effects meta-analysis to give pooled estimates. We identified 42 trials. None of the trials had low risk of bias. Seven trials of health care provider support reported 25 outcomes regarding appropriate disease management, of which 11 showed statistically significant benefits. One trial reported a statistically significant improvement in nurse/surgeon communication using mobile phones. Two trials reported statistically significant reductions in correct diagnoses using mobile technology photos compared to gold standard. The pooled effect on appointment attendance using text message (short message service or SMS) reminders versus no reminder was increased, with a relative risk (RR) of 1.06 (95% CI 1.05-1.07, I(2) = 6%). The pooled effects on the number of cancelled appointments was not significantly increased RR 1.08 (95% CI 0.89-1.30). There was no difference in attendance using SMS reminders versus other reminders (RR 0.98, 95% CI 0.94-1.02, respectively). To address the limitation of the older search, we also reviewed more recent literature. CONCLUSIONS: The results for health care provider support interventions on diagnosis and management outcomes are generally consistent with modest benefits. Trials using mobile technology-based photos reported reductions in correct diagnoses when compared to the gold standard. SMS appointment reminders have modest benefits and may be appropriate for implementation. High quality trials measuring clinical outcomes are needed. Please see later in the article for the Editors' Summary.

General Health Professions Health Information Management Public Health, Environmental and Occupational Health

Health literacy and public health: A systematic review and integration of definitions and models

BMC Public Health2012-01-25作者：Kristine Sørensen, Stephan Van den Broucke, James Fullam

BACKGROUND: Health literacy concerns the knowledge and competences of persons to meet the complex demands of health in modern society. Although its importance is increasingly recognised, there is no consensus about the definition of health literacy or about its conceptual dimensions, which limits the possibilities for measurement and comparison. The aim of the study is to review definitions and models on health literacy to develop an integrated definition and conceptual model capturing the most comprehensive evidence-based dimensions of health literacy. METHODS: A systematic literature review was performed to identify definitions and conceptual frameworks of health literacy. A content analysis of the definitions and conceptual frameworks was carried out to identify the central dimensions of health literacy and develop an integrated model. RESULTS: The review resulted in 17 definitions of health literacy and 12 conceptual models. Based on the content analysis, an integrative conceptual model was developed containing 12 dimensions referring to the knowledge, motivation and competencies of accessing, understanding, appraising and applying health-related information within the healthcare, disease prevention and health promotion setting, respectively. CONCLUSIONS: Based upon this review, a model is proposed integrating medical and public health views of health literacy. The model can serve as a basis for developing health literacy enhancing interventions and provide a conceptual basis for the development and validation of measurement tools, capturing the different dimensions of health literacy within the healthcare, disease prevention and health promotion settings.

General Health Professions Education Social Psychology