The market for healthcare data elements in China has shown strong growth, but still fails to effectively realize the value of circulation and transactions. By identifying the five major challenges, this article proposes countermeasures to accelerate the release of multidimensional value and integrative value creation of healthcare data elements.
An urban medical group in Dapeng New District was established in 2017 with the objective of enhancing outcomes for common diseases and reinforcing primary care by integrating high-level hospitals with primary health services. This study aimed to evaluate the performance of the urban medical group using the triangular value chain framework.
The evaluation was conducted using the Donabedian model, focusing on three key dimensions: safety and quality, accessibility, and affordability. Longitudinal data were collected from 2016 to 2022 through government annual reports, the medical insurance bureau, and hospital information systems. Preprogram and postprogram outcome measurements were compared to assess differences and trends, providing a clear picture of the program's effectiveness.
Accessibility improved significantly, with the number of hospital beds per 1000 residents increasing from 2.62 in 2017 to 3.76 in 2022. The availability of general practitioners (GPs) also rose markedly, from 0 per 10,000 residents in 2017 to 6.27 in 2022. Regarding safety and quality, the proportion of complex medical procedures conducted within the New District expanded substantially, from 7.35% in 2017 to 38.11% in 2021. Additionally, there was an enhancement in the standardized management rate of chronic diseases. Affordability assessments showed that the proportion of medical income derived from the medical insurance fund increased by nearly 22.81 percentage points between 2012 and 2021. By 2021, 75.02% of medical patients were covered by medical insurance, representing an increase of approximately 44 percentage points from 31.19% in 2012.
The implementation of the urban medical group in Dapeng New District has led to substantial improvements in healthcare accessibility, safety and quality, and affordability. Future initiatives will focus on advancing the “Dapeng Mode” to generate exemplary healthcare outcomes and minimize disparities in basic health services and health status between urban and rural populations. The reform agenda includes piloting payment reforms and innovative payment models within the Dapeng group, complemented by a health assessment and performance incentive system aimed at encouraging healthcare institutions to prioritize health management.
Precision medicine (PM) has taken center stage in healthcare since the completion of the genomic project. Developed countries have gradually integrated PM into mainstream patient management. However, Nigeria still grapples with wide acceptance, key translational research and implementation of PM. This study sought to explore the knowledge and attitude of PM among pharmacists as key stakeholders in the healthcare team.
A cross-sectional study was conducted in selected tertiary hospitals across the country. A 21-item semi-structured questionnaire was administered by hybrid online and physical methods and the results analyzed with Statistical Package for the Social Sciences Version 25. Descriptive statistics were used to summarize the data. A chi-square test was employed to determine the association of knowledge of PM and the sociodemographic characteristics of the study population.
A total of 167 hospital pharmacists participated in the study. A high proportion of the participants are familiar with artificial intelligence (91.75%), Pharmacogenomics (84.5%), and precision medicine (61%). Overall, 38.9% of the pharmacists had a good knowledge while 13.2% had a poor knowledge of PM and associated terms. The level of knowledge did not correlate significantly with gender (X2 = 3.21, p = 0.201), age (X2 = 5, p = 0.27), marital status (X2 = 3.21, p = 0.201), and professional level (X2 = 6.85, p = 0.144). The most important value of precision medicine to hospital pharmacists is the ability to minimize the impact of disease through preventive medicine (49%) while a large portion are pursuing and or actively planning to pursue additional education in precision medicine.
There is a highly positive attitude toward the prospect of PM among hospital pharmacists in Nigeria. Education modules in this field are highly recommended as most do not have a holistic knowledge of terms used in PM. Also, more research aimed at translating PM knowledge into clinical practice is recommended.
Deep learning (DL) has become the prevailing method in chest radiograph analysis, yet its performance heavily depends on large quantities of annotated images. To mitigate the cost, cold-start active learning (AL), comprising an initialization followed by subsequent learning, selects a small subset of informative data points for labeling. Recent advancements in pretrained models by supervised or self-supervised learning tailored to chest radiograph have shown broad applicability to diverse downstream tasks. However, their potential in cold-start AL remains unexplored.
To validate the efficacy of domain-specific pretraining, we compared two foundation models: supervised TXRV and self-supervised REMEDIS with their general domain counterparts pretrained on ImageNet. Model performance was evaluated at both initialization and subsequent learning stages on two diagnostic tasks: psychiatric pneumonia and COVID-19. For initialization, we assessed their integration with three strategies: diversity, uncertainty, and hybrid sampling. For subsequent learning, we focused on uncertainty sampling powered by different pretrained models. We also conducted statistical tests to compare the foundation models with ImageNet counterparts, investigate the relationship between initialization and subsequent learning, examine the performance of one-shot initialization against the full AL process, and investigate the influence of class balance in initialization samples on initialization and subsequent learning.
First, domain-specific foundation models failed to outperform ImageNet counterparts in six out of eight experiments on informative sample selection. Both domain-specific and general pretrained models were unable to generate representations that could substitute for the original images as model inputs in seven of the eight scenarios. However, pretrained model-based initialization surpassed random sampling, the default approach in cold-start AL. Second, initialization performance was positively correlated with subsequent learning performance, highlighting the importance of initialization strategies. Third, one-shot initialization performed comparably to the full AL process, demonstrating the potential of reducing experts' repeated waiting during AL iterations. Last, a U-shaped correlation was observed between the class balance of initialization samples and model performance, suggesting that the class balance is more strongly associated with performance at middle budget levels than at low or high budgets.
Developmental dysplasia of the hip (DDH) is a prevalent pediatric condition with a multifactorial etiology. Its incidence varies geographically, with notably higher rates observed on the Tibet plateau. This study was performed to evaluate the lipidomics signatures associated with DDH by analyzing plasma samples.
Fifty infants were recruited, including 25 diagnosed with DDH and 25 age-matched healthy controls. In addition to plasma samples, comprehensive laboratory test results and medical records were collected for each participant. An untargeted lipidomics profiling approach was employed to identify distinguishing metabolic signatures.
Lipidomics profiles differed significantly between patients with DDH and healthy controls. Several differential metabolites were identified, including triacylglycerol (TAG)(17:0/18:1/20:1), TAG(17:0/17:0/17:0), phosphatidylethanolamine (PE)(10:0/26:4), TAG(17:0/18:0/18:0), TAG(16:0/17:0/22:1), TAG(16:0/18:0/22:0), TAG(17:0/19:0/19:0), TAG(13:0/20:0/20:0), TAG(18:0/18:0/22:0), and TAG(16:0/20:0/20:0). The primary lipid species showing differences were TAGs and PE.
Distinct shifts in lipidomics profiles were observed in infants with DDH. To the best of our knowledge, this study is the first to explore lipidomics signatures in patients with DDH. The combined assessment of TAG(17:0/18:1/20:1) and TAG(17:0/17:0/17:0) may serve as a potential diagnostic tool for DDH.
RETRACTION: S. Rajput, P. K. Sharma, and R. Malviya, “Artificial Intelligence for Emergency Medical Care,” Health Care Science (Early View), https://doi.org/10.1002/hcs2.72.
The above article, published online on 13 October 2023 in Wiley Online Library (wileyonlinelibrary.com), has been retracted by agreement between the journal Editor-in-Chief, Zongjiu Zhang; Tsinghua University Press; and John Wiley & Sons Ltd. The retraction has been agreed due to unattributed overlap between this article and a previously published article [1]. The corresponding author R. Malviya disagrees with the retraction. S. Rajput and P. K. Sharma were informed of the decision to retract but remained unresponsive.
To evaluate the feasibility and safety of a novel cable-transmitted magnetically controlled capsule endoscopy (CT-MCE) system for upper gastrointestinal examination.
Twenty-six participants (19 healthy volunteers and seven patients with gastrointestinal symptoms) willing to undergo upper gastrointestinal endoscopy were recruited. Each participant underwent CT-MCE followed by conventional gastroscopy within 24 h. Maneuverability and visibility of the CT-MCE capsule in the upper gastrointestinal tract, adverse events, and discomfort during the procedure were evaluated. The sensitivity and specificity of CT-MCE for diagnosing upper gastrointestinal lesions were evaluated using conventional gastroscopy findings as the standard.
Maneuverability was graded as “good” for all segments of the esophagus. The percentage of participants in which maneuverability was good according to gastric region was as follows: cardia (100.00%), pylorus (96.15%), angulus (92.31%), antrum (88.46%), fundus (84.62%), and body (73.08%). In the duodenal bulb and descending duodenum, it was good in only 20.83% and 16.67% of participants, respectively. Visibility was graded as “excellent” or “good” in the esophagus, Z line, and duodenal bulb in all participants; excellent/good visibility was achieved in the stomach and descending duodenum in 96.15% and 79.17% of participants, respectively. Forty-one lesions were detected overall. The sensitivity and specificity of CT-MCE in diagnosing upper gastrointestinal lesions were 85.00% and 98.15%, respectively. The CT-MCE capsule was successfully removed through the mouth in all participants. No serious adverse events or capsule retention occurred.
CT-MCE showed good feasibility and safety for upper gastrointestinal examination. The system was effective in examining the esophagus and stomach with no risk of capsule retention.
The extensor carpi radial muscle may become imbalanced compared to other muscles in the upper arm and can disrupt the overall muscle balance in the upper limb. This muscular imbalance may then cause inflammation or irritation in the tendon. Regular physical activity is rarely used as the only treatment for lowering limb edema. Heavy slow resistance (HSR) training is effective compared to regular exercises. HSR affects functional abilities and physical refinement differently from conventional workouts. This study evaluated the effects of HSR and conventional exercise (CE) on subjects aged 45–65 years with unilateral elbow pain on, in Chennai city.
Patient received conservative care in the Physiotherapy Department from January 2022 to April 2022. This study compares the pre- and posttypes. Tennis Elbow Evaluation (Patient-Rated Tennis Elbow Evaluation, PRTEE) questionnaires, a patient-specific functional scale, and grip strength tests were used in the study. Results from the study's treatment HSR group and treatment CE group are contrasted.
After 12 weeks of therapy, investigators reassessed grip strength, PRTEE scores, and functional scale responses. In the posttest results of the Patient-Rated Tennis Elbow Evaluation survey, there is a statistically significant difference between Group HSR and Group CE (p < 0.001). The posttest outcomes from the patient-specific activity scoring scheme questionnaire revealed a statistically significant disparity between Groups HSR and CE (p < 0.001). The mean values for both groups exhibited a noteworthy change, with Team HSR demonstrating higher values in contrast to the control treatment.
HSR exercise demonstrates superior effectiveness over CEs for lateral epicondylitis (LE) management, emphasizing its significance in treatment.
Improving medication safety, particularly for high-risk drugs, was identified as the third Global Patient Safety Challenge by the World Health Organization in 2017. Antineoplastic agents are included in the list of high-risk medications because of their high potential to cause adverse events. This study evaluated the effectiveness of a project that was implemented to improve the antineoplastic therapy compounding process at a university hospital.
This study had a quasi-experimental before-and-after design and used a quantitative approach to investigate the effects of implementation of this project in a centralized intravenous admixture service. The compounding of antineoplastic therapy was evaluated using five quality criteria at three time points: an initial evaluation and two post-intervention re-evaluations. The results of the intervention were subjected to statistical analysis and are presented in a Pareto chart.
All five quality criteria for correct compounding of antineoplastic therapy improved after implementation of the intervention, with an increase in compliance values for all criteria after the second evaluation. Improvements in criteria 1, 3, and 4 were statistically significant.
The implementation of the improvement project enhanced the quality criteria and caused a cultural shift in the team, with an improved view towards quality management in work processes.
RETRACTION: P. Goyal and R. Malviya, “Challenges and Opportunities of Big Data Analytics in Healthcare,” Health Care Science 2, no. 5 (2023): 328–338, https://doi.org/10.1002/hcs2.66.
The above article, published online on 4 October 2023 in Wiley Online Library (wileyonlinelibrary.com), has been retracted by agreement between the journal Editor-in-Chief, Zongjiu Zhang; Tsinghua University Press; and John Wiley & Sons Ltd. The retraction has been agreed due to unattributed overlap between this article and a previously published article [1]. The corresponding author R. Malviya disagrees with the retraction. P. Goyal was informed of the decision to retract but remained unresponsive.
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