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Multimorbidity in neurodegenerative diseases: a network analysis. 神经退行性疾病的多病症:网络分析。
Pub Date : 2024-10-03 DOI: 10.1080/17538157.2024.2405869
Mostafa Amini, Ali Bagheri, Martin P Paulus, Dursun Delen

The socioeconomic costs of neurodegenerative diseases (NDs) are highly affected by comorbidities. This study aims to enhance our understanding of the prevalent complications of NDs through the lens of network analysis. A multimorbidity network (MN) was constructed based on a longitudinal EHR dataset of 93,647,498 diagnoses of 824,847 patients. The association between the conditions was measured by two metrics, i.e. Phi-correlation and Cosine Index (CI). Based on multiple network centrality measures, a fused ranking list of the prevalent multimorbidities was provided. Finally, class-level networks depicting the prevalence and strength of diseases in different classes were constructed. The general MN included 928 diseases and 337,253 associations. Considering a 99% confidence level, two networks of 575 relationships were constructed based on Phi-correlations (73 diseases) and CI (102 diseases). Five out of 19 ICD-9 categories did not appear in either of the networks. Also, ND's immediate MNs for the top 50% of the significant associations included 42 relationships, whereas the Phi-correlation and CI networks included 36 and 34 diseases, respectively. Thirteen diseases were identified as the most notable multimorbidities based on various centrality measures. The analysis framework helps practitioners toward better resource allocations, more effective preventive screenings, and improved quality of life for ND patients and caregivers.

神经退行性疾病(NDs)的社会经济成本深受并发症的影响。本研究旨在通过网络分析的视角,加深我们对神经退行性疾病普遍并发症的了解。多病网络(MN)的构建基于纵向电子病历数据集,该数据集包含 824,847 名患者的 93,647,498 项诊断。病症之间的关联通过两个指标来衡量,即腓相关和余弦指数(CI)。根据多种网络中心度量,提供了一份多病流行的融合排序列表。最后,构建了描述不同等级疾病流行率和强度的等级网络。一般 MN 包括 928 种疾病和 337 253 个关联。考虑到 99% 的置信度,根据 Phi-相关性(73 种疾病)和 CI(102 种疾病)构建了两个包含 575 种关系的网络。在 19 个 ICD-9 类别中,有 5 个没有出现在这两个网络中。此外,ND 的前 50% 重要关联的直接 MN 包括 42 种关系,而 Phi 相关性和 CI 网络分别包括 36 种和 34 种疾病。根据各种中心度量,有 13 种疾病被确定为最值得注意的多病症。该分析框架有助于从业人员更好地分配资源、更有效地进行预防性筛查以及提高 ND 患者和护理人员的生活质量。
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引用次数: 0
Identifying biological markers and sociodemographic factors that influence the gap between phenotypic and chronological ages. 确定影响表型年龄和计时年龄之间差距的生物标记和社会人口因素。
Pub Date : 2024-09-24 DOI: 10.1080/17538157.2024.2400247
Daniele Pala, Jia Xu, Yuezhi Xie, Yuqin Zhang, Li Shen

Introduction: The world's population is aging rapidly, leading to increased public health and economic burdens due to age-related cardiovascular and neurodegenerative diseases. Early risk detection is essential for prevention and to improve the quality of life in elderly individuals. Plus, health risks associated with aging are not directly tied to chronological age, but are also influenced by a combination of environmental exposures. Past research has introduced the concept of "Phenotypic Age," which combines age with biomarkers to estimate an individual's health risk.

Methods: This study explores which factors contribute most to the gap between chronological and phenotypic ages. We combined ten machine learning regression techniques applied to the NHANES dataset, containing demographic, laboratory and socioeconomic data from 41,474 patients, to identify the most important features. We then used clustering analysis and a mixed-effects model to stratify by sex, ethnicity, and education.

Results: We identified 28 demographic, biological and environmental factors related to a significant gap between phenotypic and chronological ages. Stratifying for sex, education and ethnicity, we found statistically significant differences in the outcome distributions.

Conclusion: By showing that health risk prevention should consider both biological and sociodemographic factors, we offer a new approach to predict aging rates and potentially improve targeted prevention strategies for age-related conditions.

导言:世界人口正在迅速老龄化,与年龄相关的心血管和神经退行性疾病增加了公共卫生和经济负担。早期风险检测对于预防和提高老年人的生活质量至关重要。此外,与衰老相关的健康风险并不直接与年龄相关,还受到环境暴露的综合影响。过去的研究提出了 "表型年龄 "的概念,即结合年龄和生物标志物来估计个人的健康风险:本研究探讨了哪些因素是造成计时年龄与表型年龄之间差距的主要原因。我们将十种机器学习回归技术结合应用于 NHANES 数据集,其中包含 41,474 名患者的人口学、实验室和社会经济数据,以确定最重要的特征。然后,我们使用聚类分析和混合效应模型按性别、种族和教育程度进行分层:结果:我们确定了 28 个与表型年龄和实际年龄之间存在显著差距有关的人口、生物和环境因素。根据性别、教育程度和种族进行分层后,我们发现结果分布存在显著的统计学差异:通过证明健康风险预防应同时考虑生物和社会人口因素,我们提供了一种预测老龄化率的新方法,并有可能改进针对老年相关疾病的预防策略。
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引用次数: 0
Functional size measurement of postnatal care apps: Morocco case study. 产后护理应用程序的功能大小测量:摩洛哥案例研究。
Pub Date : 2024-04-02 Epub Date: 2024-03-26 DOI: 10.1080/17538157.2024.2332693
Karima Moumane, Lamyae Sardi, Ali Idri, Alain Abran

This study empirically evaluates the functionality coverage of 18 mobile applications (apps) for Postnatal care including a recently developed app in Morocco "Mamma&Baby". This evaluation is based on a comparison of the COSMIC _ISO 19,761 functional size of these apps with the score obtained in a previous evaluation based on functions extraction through a quality assessment questionnaire. This comparison allows to discuss the relationship between the functional size of the 18 apps, their users' ratings in the Play Store as well as the number of downloads. While for most of the assessed apps, there is only a small shift between the rankings of the two evaluations, for some apps, the shift is huge due to the number of features added and not covered by the score previously obtained. This study illustrates the use of COSMIC as an effective method for corrective or evolutionary updates since it takes into account all the functions and features of postnatal apps. For the "Mamma&Baby" app, efforts are required to boost the number of downloads, optimize its visibility, and attract the highest number of users.

本研究对 18 款产后护理移动应用程序(App)的功能覆盖范围进行了实证评估,其中包括摩洛哥最近开发的一款应用程序 "Mamma&Baby"。该评估基于这些应用程序的 COSMIC _ISO 19,761 功能大小与之前通过质量评估问卷进行功能提取的评估所获得的分数进行比较。通过比较,我们可以讨论这 18 款应用程序的功能大小、用户在 Play Store 中的评分以及下载量之间的关系。对于大多数被评估的应用程序来说,两次评估的排名仅有微小的变化,但对于某些应用程序来说,由于增加了一些功能,而之前获得的分数并没有涵盖这些功能,因此变化是巨大的。这项研究说明,COSMIC 是一种有效的修正或进化更新方法,因为它考虑到了产后应用程序的所有功能和特点。对于 "Mamma&Baby "应用程序来说,需要努力提高下载量,优化其知名度,吸引更多用户。
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引用次数: 0
Usability testing of a mobile health application to support individuals with active tuberculosis: a mixed methods study. 支持活动性肺结核患者的移动医疗应用程序可用性测试:一项混合方法研究。
Pub Date : 2024-04-02 Epub Date: 2024-03-26 DOI: 10.1080/17538157.2024.2333379
Alexander John Stabile, Sarah Iribarren, Jennifer Sonney, George Demiris, Rebecca Schnall

Poor adherence to tuberculosis (TB) treatment leads to further disease transmission, worsened outcomes, and the development of drug resistance. Digital adherence technologies may facilitate a more patient-centered approach for improving TB treatment outcomes than current strategies. The objective of this study was to evaluate and explore improving usability of the TB Treatment Support Tools (TB-TST) mobile application. We used an iterative convergent mixed-method design consisting of two quantitative surveys and a qualitative think-aloud interview. Testing was conducted in three testing cycles consisting of a total of 16 interviews and 26 surveys. Results were thematically analyzed and reported to the development team during weekly team meetings. Participants rated the TB-TSTs application as having high usability and the iterative approach resulted in several refinements to the application in response to participant feedback. These refinements were well received during qualitative interviews but did not result in a statistically significant improvement in usability testing scores between cycles. Using an iterative convergent mixed-method design was an effective method for refining our mHealth application. Data collected from think-aloud interviews, the MAUQ, and the Health-ITUES identified key areas of application design that needed refinement.

结核病(TB)治疗依从性差会导致疾病进一步传播、治疗效果恶化以及耐药性的产生。与目前的策略相比,数字坚持治疗技术可能有助于采用更加以患者为中心的方法来改善结核病的治疗效果。本研究旨在评估和探索如何提高结核病治疗支持工具(TB-TST)移动应用程序的可用性。我们采用了一种迭代收敛混合方法设计,包括两项定量调查和一项定性畅想访谈。测试分三个测试周期进行,共进行了 16 次访谈和 26 次调查。测试结果经过专题分析,并在每周的团队会议上向开发团队汇报。参与者认为 TB-TSTs 应用程序具有很高的可用性,迭代方法根据参与者的反馈对应用程序进行了多次改进。在定性访谈中,这些改进受到好评,但在不同周期的可用性测试得分中并没有统计意义上的显著改进。使用迭代收敛混合方法设计是改进移动医疗应用程序的有效方法。通过畅想访谈、MAUQ 和 Health-ITUES 收集到的数据确定了应用程序设计中需要改进的关键领域。
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引用次数: 0
How satisfied are patients with nursing care and why? A comprehensive study based on social media and opinion mining. 患者对护理服务的满意度如何?基于社交媒体和意见挖掘的综合研究。
Pub Date : 2024-01-02 Epub Date: 2024-01-04 DOI: 10.1080/17538157.2023.2297307
Jesus Serrano-Guerrero, Mohammad Bani-Doumi, Francisco Chiclana, Francisco P Romero, Jose A Olivas

To assess the overall experience of a patient in a hospital, many factors must be analyzed; nonetheless, one of the key aspects is the performance of nurses as they closely interact with patients on many occasions. Nurses carry out many tasks that could be assessed to understand the patient's satisfaction and consequently, the effectiveness of the offered services. To assess their performance, traditionally, expensive, and time-consuming methods such as questionnaires and interviews have been used; nevertheless, the development of social networks has allowed the patients to convey their opinions in a free and public manner. For that reason, in this study, a comprehensive analysis has been performed based on patients' opinions collected from a feedback platform for health and care services, to discover the topics about nurses the patients are more interested in. To do so, a topic modeling technique has been proposed. After this, sentiment analysis has been applied to classify the topics as satisfactory or unsatisfactory. Finally, the results have been compared with what the patients think about doctors. The results highlight what topics are most relevant to assess the patient satisfaction and to what extent. The results remark that the opinion about nurses is, in general, more positive than about doctors.

要评估病人在医院的整体体验,必须对许多因素进行分析;然而,其中一个关键方面是护士的表现,因为她们在许多场合都与病人密切互动。护士执行的许多任务都可以通过评估来了解病人的满意度,进而了解所提供服务的有效性。为了评估护士的工作表现,传统上会使用问卷调查和访谈等昂贵且耗时的方法;然而,社交网络的发展使得患者可以自由、公开地表达他们的意见。因此,在本研究中,我们根据从医疗和护理服务反馈平台收集到的患者意见进行了综合分析,以发现患者更感兴趣的护士话题。为此,我们提出了一种主题建模技术。之后,应用情感分析将话题分为满意和不满意。最后,将结果与患者对医生的看法进行比较。结果强调了哪些话题与评估患者满意度最相关,以及在多大程度上相关。结果表明,对护士的评价总体上比对医生的评价更积极。
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引用次数: 0
Empowering the digital health workforce in Latin America in the context of the COVID-19 pandemic: the Peruvian case. 在 COVID-19 大流行的背景下增强拉丁美洲数字医疗队伍的能力:秘鲁案例。
Pub Date : 2024-01-02 Epub Date: 2024-02-13 DOI: 10.1080/17538157.2024.2315266
Walter H Curioso, Lelis G Coronel-Chucos, Elsa Oscuvilca-Tapia

The COVID-19 pandemic has exposed significant gaps in healthcare access, quality, and the urgent need for enhancing the capacity of digital health human resources, particularly in Latin America. During the pandemic, online courses and telehealth initiatives supported by governmental agencies, the Pan American Health Organization, and other public and private resources, have played a crucial role in meeting training demands. This article discusses the role of capacity building programs in digital health within the context of Latin America, with a specific focus on the Peruvian case. We highlight the development of digital health competencies and related policies, while also describing selected experiences related to capacity building in this field. Additionally, we discuss the pivotal role of collaborative partnerships among institutions and countries, emphasizing the importance of culturally relevant training programs in digital health. These initiatives have the potential to accelerate training and research opportunities in Latin America, drawing on the involvement of government agencies, non-governmental organizations, industry, universities, professional societies, and communities.

COVID-19 大流行暴露了医疗保健在获取和质量方面的巨大差距,以及提高数字医疗人力资源能力的迫切需要,尤其是在拉丁美洲。在大流行期间,由政府机构、泛美卫生组织以及其他公共和私人资源支持的在线课程和远程医疗计划在满足培训需求方面发挥了至关重要的作用。本文以秘鲁为例,讨论了数字医疗能力建设项目在拉丁美洲的作用。我们强调了数字医疗能力和相关政策的发展,同时还介绍了与该领域能力建设相关的部分经验。此外,我们还讨论了机构间和国家间合作伙伴关系的关键作用,强调了与文化相关的数字健康培训计划的重要性。在政府机构、非政府组织、行业、大学、专业协会和社区的参与下,这些举措有可能加快拉丁美洲的培训和研究机会。
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引用次数: 0
Perceptions of pre-licensure nursing students toward telecare and telenursing. 执照前护理专业学生对远程护理和远程护理的看法。
Pub Date : 2024-01-02 Epub Date: 2024-01-11 DOI: 10.1080/17538157.2024.2303642
Izzeddin A Bdair

Telehealth transforms the healthcare system and provides the population with equal access to healthcare services at distance. This study aimed to investigate nursing students' perceptions toward telenursing. Students' knowledge, attitudes, advantages, disadvantages, barriers, and factors that affect the intention toward telenursing implementation were addressed. This study was conducted using a descriptive design. The study participants were 313 undergraduate nursing students. Data were gathered through a web-based survey from June to August 2022 and analyzed using SPSS version 22. Fifty-four-point-six percent (54.6%) of the students were male and 45.4% were female. Around one-fourth were internship students. Most students had access to the internet 97.4%. The results revealed that nursing students have positive perceptions toward telenursing. Their overall competencies in terms of knowledge, proficiency, awareness, and familiarity were moderate. Students raised some disadvantages and difficulties regarding telenursing; meanwhile, more advantages and suggestions to overcome the disadvantages were reported. It is of utmost importance that nursing education integrates telenursing content and practice to prepare future nurses for the successful implementation of telenursing. More research is still needed to examine the impact of telenursing on nursing practice. Nursing administrators must develop appropriate and prompt interventions to respond to the dramatically changing healthcare environment.

远程医疗改变了医疗系统,为人们提供了平等的远程医疗服务。本研究旨在调查护理专业学生对远程护理的看法。研究涉及学生的知识、态度、优势、劣势、障碍以及影响远程护理实施意向的因素。本研究采用描述性设计。研究参与者为 313 名护理专业本科生。数据是在 2022 年 6 月至 8 月期间通过网络调查收集的,并使用 SPSS 22 版进行了分析。54.6%的学生为男生,45.4%为女生。约四分之一是实习学生。大多数学生都能上网,占 97.4%。结果显示,护理专业学生对远程护理持积极态度。他们在知识、熟练程度、意识和熟悉程度方面的总体能力处于中等水平。学生们提出了远程护理的一些缺点和困难,同时也报告了更多的优点和克服缺点的建议。最重要的是,护理教育应将远程护理内容与实践相结合,为未来护士成功实施远程护理做好准备。还需要更多的研究来探讨远程护理对护理实践的影响。护理管理者必须制定适当而迅速的干预措施,以应对急剧变化的医疗环境。
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引用次数: 0
Algorithmic identification of persons with dementia for research recruitment: ethical considerations. 对痴呆症患者进行算法识别以招募研究人员:伦理考虑。
Pub Date : 2024-01-02 Epub Date: 2024-01-10 DOI: 10.1080/17538157.2023.2299881
Alex John London, Jason Karlawish, Emily A Largent, Spencer Phillips Hey, Ellen P McCarthy

Underdiagnosis, misdiagnosis, and patterns of social inequality that translate into unequal access to health systems all pose barriers to identifying and recruiting diverse and representative populations into research on Alzheimer's disease and Alzheimer's disease related dementias. In response, some have turned to algorithms to identify patients living with dementia using information that is associated with this condition but that is not as specific as a diagnosis. This paper explains six ethical issues associated with the use of such algorithms including the generation of new, sensitive, identifiable medical information for research purposes without participant consent, issues of justice and equity, risk, and ethical communication. It concludes with a discussion of strategies for addressing these issues and prompting valuable research.

诊断不足、误诊以及社会不平等模式导致的医疗系统使用权不平等,这些都阻碍了阿尔茨海默病和阿尔茨海默病相关痴呆症研究中识别和招募多样化、有代表性的人群。为此,一些人转而采用算法,利用与痴呆症相关但不像诊断那样具体的信息来识别痴呆症患者。本文解释了与使用此类算法相关的六个伦理问题,包括未经参与者同意为研究目的生成新的、敏感的、可识别的医疗信息、公正与公平问题、风险问题以及伦理交流问题。最后,本文讨论了解决这些问题并促进有价值研究的策略。
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引用次数: 0
Old age or cognitive decline? Examining the usability of a mobile health app for older Australians. 年老还是认知能力下降?研究针对澳大利亚老年人的移动健康应用程序的可用性。
Pub Date : 2024-01-02 Epub Date: 2024-03-26 DOI: 10.1080/17538157.2024.2332691
Breda McCarthy, Jagdeep Kaur Sabharwal, Shailey Chawla

There is a growing literature on the role of mobile health applications (mHealth apps) in supporting older adults and the self-management of personal health. The purpose of this pilot study is to assess the usability of a government-funded mobile health app amongst older Australians and to evaluate whether cognitive function and demographic characteristics (i.e. age, gender, education) are associated with usability. A total of 28 older adults living in a regional city in Australia took part in the study. The participants were recruited using purposive sampling. Data collection instruments consisted of validated cognitive tests, task-based usability tests, and a questionnaire. The data was analyzed using non-parametric strategies. The findings of this study demonstrated that a government-funded, mHealth app was usable by older adults. Users were able to perform basic tasks in an effective and efficient manner. The hypothesis that elderly age would be significantly associated with performance on cognitive tests, as well as usability, was not supported. Performance on some cognitive tests was significantly and positively related to usability. Education and gender were not related to usability. The results suggest that traditional stereotypes surrounding aging and cognitive decline need to be reexamined.

关于移动医疗应用程序(mHealth apps)在支持老年人和个人健康自我管理方面所起作用的文献越来越多。本试点研究旨在评估政府资助的移动医疗应用程序在澳大利亚老年人中的可用性,并评估认知功能和人口特征(即年龄、性别、教育程度)是否与可用性相关。共有 28 名居住在澳大利亚某地区城市的老年人参与了这项研究。研究人员是通过有目的的抽样方式招募的。数据收集工具包括经过验证的认知测试、基于任务的可用性测试和调查问卷。数据采用非参数策略进行分析。研究结果表明,老年人可以使用政府资助的移动医疗应用程序。用户能够有效、高效地完成基本任务。关于老年人的年龄与认知测试成绩和可用性有显著关联的假设没有得到支持。某些认知测试的成绩与可用性有明显的正相关。教育程度和性别与可用性无关。研究结果表明,需要重新审视围绕老龄化和认知能力衰退的传统刻板印象。
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引用次数: 0
Predicting COVID-19 new cases in California with Google Trends data and a machine learning approach. 利用谷歌趋势数据和机器学习方法预测加利福尼亚州的 COVID-19 新病例。
Pub Date : 2024-01-02 Epub Date: 2024-02-14 DOI: 10.1080/17538157.2024.2315246
Amir Habibdoust, Maryam Seifaddini, Moosa Tatar, Ozgur M Araz, Fernando A Wilson

Background: Google Trends data can be a valuable source of information for health-related issues such as predicting infectious disease trends.

Objectives: To evaluate the accuracy of predicting COVID-19 new cases in California using Google Trends data, we develop and use a GMDH-type neural network model and compare its performance with a LTSM model.

Methods: We predicted COVID-19 new cases using Google query data over three periods. Our first period covered March 1, 2020, to July 31, 2020, including the first peak of infection. We also estimated a model from October 1, 2020, to January 7, 2021, including the second wave of COVID-19 and avoiding possible biases from public interest in searching about the new pandemic. In addition, we extended our forecasting period from May 20, 2020, to January 31, 2021, to cover an extended period of time.

Results: Our findings show that Google relative search volume (RSV) can be used to accurately predict new COVID-19 cases.  We find that among our Google relative search volume terms, "Fever," "COVID Testing," "Signs of COVID," "COVID Treatment," and "Shortness of Breath" increase model predictive accuracy.

Conclusions: Our findings highlight the value of using data sources providing near real-time data, e.g., Google Trends, to detect trends in COVID-19 cases, in order to supplement and extend existing epidemiological models.

背景:谷歌趋势数据是预测传染病趋势等健康相关问题的宝贵信息来源:为了评估利用谷歌趋势数据预测加利福尼亚州 COVID-19 新病例的准确性,我们开发并使用了 GMDH 型神经网络模型,并将其性能与 LTSM 模型进行了比较:我们利用谷歌查询数据预测了三个时期的 COVID-19 新病例。第一个时段为 2020 年 3 月 1 日至 2020 年 7 月 31 日,包括第一个感染高峰期。我们还估算了 2020 年 10 月 1 日至 2021 年 1 月 7 日的模型,其中包括 COVID-19 的第二波,并避免了公众在搜索新流行病时可能产生的偏差。此外,我们还将预测期从 2020 年 5 月 20 日延长至 2021 年 1 月 31 日,以覆盖更长的时间段:我们的研究结果表明,谷歌相对搜索量(RSV)可用于准确预测 COVID-19 新病例。 我们发现,在谷歌相对搜索量词条中,"发热"、"COVID 检测"、"COVID 征兆"、"COVID 治疗 "和 "呼吸急促 "提高了模型预测的准确性:我们的研究结果凸显了利用提供近实时数据的数据源(如谷歌趋势)来检测 COVID-19 病例趋势的价值,从而补充和扩展现有的流行病学模型。
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引用次数: 0
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Informatics for health & social care
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