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Is It Time to Revise the Competency-Based Assessment? Objective Structured Clinical Examination and Technology Integration 是时候修改基于能力的评估了吗?目的结构化临床检验与技术整合
Q3 Medicine Pub Date : 2023-09-16 DOI: 10.5812/semj-138785
Haniye Mastour, Nazanin Shamaeian Razavi
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引用次数: 0
Establishment and Utilization of Electronic Health Records in Iran: A Review of the Policy Documents of the Past Four Decades 伊朗电子健康档案的建立和利用:对过去四十年政策文件的回顾
Q3 Medicine Pub Date : 2023-09-12 DOI: 10.5812/semj-137492
Mohammad Bakhtiari Aliabad, Niusha Sadeghi, Mahdi Mokhtari-Payam, Somayeh Seddighi, Seyed Jafar Ehsanzadehsorati, Fatemeh Mohammad Beygi
Background: This study presents the legal obligations set for the main stakeholders in the establishment and implementation of electronic health (e-health) records in Iran and investigates the fulfillment of these obligations. Methods: This qualitative study was conducted using document analysis. The research population comprised all the documents, laws, reports, and policies of the establishment and utilization of electronic health records in Iran. Sampling was purposive, and all the internal documents of Iran were included until the end of May 2022. A data extraction form was used to collect the data, and Scott's criterion was used to select the documents. Descriptive analysis was used to analyze the data. Results: Based on the documents, 56% of the sentences were implemented, and 22% were not enforced according to the assigned tasks. The status of the execution of tasks by the main players was also extracted. The most important of these included the drafting of the electronic health security and privacy regulations, not providing the conditions for receiving electronic copies in the e-records, creating internal automation for the Ministry of Health and Medical Education instead of the e-health records system, instability of the integrated portal for exchanging health information and disconnection of the majority of service centers, eliminating the extension of the validity of paper booklets, operationalizing the online entitlement system, using the first phase of the electronic prescription project, not inserting nursing notes in the records, recording financial and administrative information instead of clinical ones, refusal of numerous doctors to write electronic prescriptions, using an alternative method of two-step verification instead of electronic signature, the progress of coding and drug authenticity, and the non-implementation of medical equipment coding. Conclusions: Reviewing the status of the enforcement of approvals also revealed that the format of actions since 2018 has ended with a positive result. The main achievement so far has been electronic prescription, while it should be noted that prescription is only part of the electronic health record project.
背景:本研究提出了在伊朗建立和实施电子健康(e-health)记录的主要利益相关者的法律义务,并调查了这些义务的履行情况。方法:采用文献分析法进行定性研究。研究对象包括伊朗建立和利用电子健康记录的所有文件、法律、报告和政策。抽样是有目的的,直到2022年5月底,伊朗的所有内部文件都被纳入。使用数据提取表收集数据,使用Scott标准选择文档。采用描述性分析对数据进行分析。结果:根据文件,56%的句子得到了执行,22%的句子没有按照指定的任务执行。还提取了主要参与者执行任务的状态。其中最重要的包括起草电子卫生安全和隐私条例,不提供接收电子记录中的电子副本的条件,为卫生和医学教育部创建内部自动化系统,而不是电子卫生记录系统,交换卫生信息的综合门户网站不稳定,大多数服务中心断开连接,取消纸质小册子的有效期延长,在线授权系统的运行,使用电子处方项目的第一阶段,在记录中不插入护理笔记,记录财务和行政信息而不是临床信息,许多医生拒绝写电子处方,使用两步验证替代电子签名的替代方法,编码和药物真实性的进展,以及未实施医疗设备编码。结论:审查批准的执行状况还显示,自2018年以来的行动形式已取得积极成果。到目前为止,主要的成果是电子处方,但需要注意的是,处方只是电子健康档案项目的一部分。
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引用次数: 0
Investigating the Level of Preparedness of Iranian Hospitals against CBRN Incidents: A Case Study of Hospitals in West Azerbaijan Province 调查伊朗医院对CBRN事件的防范水平:以西阿塞拜疆省医院为例研究
Q3 Medicine Pub Date : 2023-09-10 DOI: 10.5812/semj-133707
Saeed Beikmohammadi, Baqer Amir Heidari, Tania Dahesh, Mahmood Nekoei-Moghadam, Vahid Yazdi-Feyzabadi, Ebrahim Hassani, Hossein Habibzadeh
Background: Hospitals are the front line of dealing with Incidents. Chemical, biological, radiological, and nuclear (CBRN) incidents are alarming for governments' healthcare providers and the public. Therefore, they must make the necessary preparations to deal with these incidents. Objectives: This study aimed to evaluate the preparedness of hospitals against chemical, biological, radiological, and nuclear incidents and the related influential factors. Methods: The present study was a cross-sectional survey in northwest Iran, 2020-2022. The statistical population was the hospitals of West Azerbaijan province. The inclusion criteria were that hospitals must be university or therapeutic affiliated with the West Azerbaijan University of Medical Sciences, and at least one year had to be passed since the hospital’s operation. Also, the exclusion criteria were that the hospitals were on the verge of closing or changing their use. In this way, 26 hospitals in West Azerbaijan were studied. The "Canadian Center for Emergency Preparedness" evaluation checklist research tool was used to determine the level of preparedness of the studied hospitals in CBRN incidents. The data was collected for 5 months, from January to May 2021. Cronbach's alpha score for this checklist was 0.94. Descriptive and analytical statistics indicators were used for data analysis using SPSS 20 software. Results: The study showed that the hospitals lacked the preparation, capacities, and abilities to deal with CBRN incidents. In the single-variable mode, in the chemical dimension, the number of morgues of the deceased (P = 0.006); in the biological aspect, per capita educational factors in the biological domain (P = 0.03), the number of facility personnel (P = 0.04), the number of infectious disease specialists (P = 0.02), the number of equipment with optimal laboratory capabilities (P = 0.04), and the number of morgues of the deceased (P = 0.006); in the radiological and nuclear dimensions per capita of nuclear education (P = 0.01) and dosimeter (P = 0.03), and the general dimension the CBRN training per capita (P = 0.004), the number of personnel (P = 0.015), and laboratory equipment (P = 0.006) had a significant relationship with the preparedness of hospitals against CBRN incidents (P < 0.05). Conclusions: Overall, this study's results showed that hospitals' preparedness against CBRN incidents was unsatisfactory, and appropriate policies needed to be adopted to improve it.
背景:医院是处理突发事件的第一线。化学、生物、放射性和核(CBRN)事件令政府的医疗保健提供者和公众感到震惊。因此,他们必须做好必要的准备来处理这些事件。目的:探讨医院应对化学、生物、放射和核事故的准备工作及其影响因素。方法:本研究是2020-2022年在伊朗西北部进行的横断面调查。统计人口为西阿塞拜疆省的医院。纳入标准是,医院必须是西阿塞拜疆医科大学附属的大学或治疗机构,并且医院开业至少一年。此外,排除标准是医院即将关闭或改变用途。通过这种方式,研究了西阿塞拜疆的26家医院。使用"加拿大应急准备中心"评估清单研究工具来确定所研究医院对CBRN事件的准备水平。数据收集时间为5个月,即2021年1月至5月。Cronbach’s alpha评分为0.94。采用描述性统计指标和分析性统计指标,采用SPSS 20软件进行数据分析。结果:研究表明,医院缺乏应对CBRN事件的准备、能力和能力。在单变量模式下,在化学维度上,死者停尸房的数量(P = 0.006);在生物方面,生物领域的人均受教育程度(P = 0.03)、设施人员人数(P = 0.04)、传染病专家人数(P = 0.02)、具有最佳实验室能力的设备数量(P = 0.04)和死者停尸房数量(P = 0.006);在人均核教育(P = 0.01)和剂量计(P = 0.03)的放射和核维度,以及人均CBRN培训(P = 0.004)的一般维度,人员数量(P = 0.015)和实验室设备(P = 0.006)与医院应对CBRN事件的准备有显著关系(P <0.05)。结论:总体而言,本研究的结果表明,医院对CBRN事件的准备工作令人不满意,需要采取适当的政策来改进。
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引用次数: 0
Association Between Temporomandibular Joint Disorders and Salivary Cortisol Levels: A Systematic Review and Meta-Analysis 颞下颌关节疾病与唾液皮质醇水平的关系:一项系统综述和荟萃分析
Q3 Medicine Pub Date : 2023-08-26 DOI: 10.5812/semj-137608
H. Eslami, Bita Azizi, K. Katebi, Z. Hoseini
Context: Salivary cortisol could be a good marker for temporomandibular joint disorders. This article aimed to study the association between salivary cortisol and temporomandibular joint disorders (TMD). Methods: PubMed, Web of Science, Scopus, and Embase were searched according to the PRISMA guidelines without restricting the publication start date until October 2022. Only case-control studies were included in the study. The critical appraisal checklist of the Joanna Briggs Institute was utilized to appraise the selected articles. Results: Of 1173 articles found, 23 studies were eligible, and 18 were meta-analyzed. A total of 696 TMD patients and 785 controls were included. Meta-analysis showed that salivary cortisol was significantly higher in patients with TMD than the controls. Meta-regression showed that the difference in mean salivary cortisol decreased significantly between the two groups with increasing age. Conclusions: The salivary cortisol in patients with TMD is significantly higher than in the controls. As the heterogeneity among the studies was high, more studies are required to verify this association.
背景:唾液皮质醇可能是颞下颌关节疾病的一个很好的标志。本文旨在探讨唾液皮质醇与颞下颌关节疾病(TMD)的关系。方法:根据PRISMA指南检索PubMed、Web of Science、Scopus和Embase,不限制出版日期至2022年10月。本研究仅纳入病例对照研究。使用乔安娜布里格斯研究所的关键评估清单来评估选定的文章。结果:在发现的1173篇文章中,23篇研究符合条件,18篇进行了meta分析。共纳入696例TMD患者和785例对照。荟萃分析显示,TMD患者的唾液皮质醇明显高于对照组。meta回归显示,随着年龄的增加,两组间平均唾液皮质醇的差异显著降低。结论:TMD患者唾液皮质醇水平明显高于对照组。由于研究之间的异质性较高,需要更多的研究来验证这种关联。
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引用次数: 0
Effect of Three Educational Methods on Anxiety and Hemodynamics of Candidates for Exercise Stress Test: A Double-blinded Randomized Controlled Trial 三种教育方法对运动应激测试考生焦虑和血流动力学的影响:一项双盲随机对照试验
Q3 Medicine Pub Date : 2023-08-14 DOI: 10.5812/semj-136829
Maani Beizaei, C. Torabizadeh, Sara Shojaei‐Zarghani, A. Safarpour, M. Mehrabi, M. Jorat
Background: Exercise stress test (EST) is commonly performed to diagnose cardiovascular diseases. Patients undergoing EST usually experience anxiety and stress mainly because they lack knowledge about the test. Objectives: The present double-blinded randomized controlled trial aimed to compare the effects of education via face-to-face, interactive multimedia, and short messaging service (SMS) methods on anxiety level (main outcome) and vital signs (secondary outcomes) in candidates for EST. Methods: Candidates of EST with moderate to severe anxiety were allocated randomly (block size of 6) to receive education via the face-to-face routine method (control, n = 47), multimedia (n = 48), or SMS (n = 49). The educational content was similar in the groups and focused on EST methods, preparations, and potential adverse effects. Anxiety was assessed at baseline and one week after education. The patients’ blood pressure and pulse rate were measured at baseline, before, and after the EST. Results: One-hundred-forty-four patients completed the study. The post-intervention anxiety reduced significantly in the SMS group compared to the control group (P < 0.001, Cohen’s d = -1.09) and in the SMS group compared to the multimedia group (P < 0.001, Cohen’s d = -0.83). The anxiety score was not significantly different between the multimedia and control groups (P = 0.454, Cohen’s d = -0.26), although within-group comparison showed a significant decrease in the multimedia and SMS groups. Patients who received education via SMS also experienced lower pulse rates than those in the control group. Conclusions: Because of the effectiveness of education via SMS in decreasing patients’ anxiety scores, we recommend using this method to prevent anxiety before EST, especially in developing and low-income countries.
背景:运动应激试验(EST)是诊断心血管疾病的常用方法。接受EST的患者通常会感到焦虑和压力,主要是因为他们对这项测试缺乏了解。目的:本双盲随机对照试验旨在比较面对面教育、交互式多媒体教育和短信教育对EST考生焦虑水平(主要结局)和生命体征(次要结局)的影响。方法:EST考生有中度至重度焦虑,随机分配(组大小为6),分别接受面对面常规教育(对照组,n = 47)、多媒体教育(n = 48)和短信教育(n = 49)。各组的教育内容相似,并侧重于EST的方法、准备和潜在的不良反应。焦虑在基线和教育后一周进行评估。在EST之前和之后分别测量患者的血压和脉搏率。结果:144名患者完成了研究。短信组干预后焦虑水平较对照组显著降低(P < 0.001, Cohen’s d = -1.09),短信组干预后焦虑水平较多媒体组显著降低(P < 0.001, Cohen’s d = -0.83)。多媒体组和对照组的焦虑得分差异无统计学意义(P = 0.454, Cohen’s d = -0.26),但组内比较显示多媒体组和短信组的焦虑得分显著降低。通过短信接受教育的患者脉搏率也低于对照组。结论:由于短信教育在降低患者焦虑评分方面的有效性,我们建议在EST前使用这种方法预防焦虑,特别是在发展中国家和低收入国家。
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引用次数: 0
The Quality of Life of Trauma Patients with Splint Immobilization 夹板固定对创伤患者生活质量的影响
Q3 Medicine Pub Date : 2023-08-10 DOI: 10.5812/semj-136752
Mohamad Hoseini Kasnavieh, S. Mousavi, M. Veisi, A. Tahmasebi
Background: Different countries have used different methods to reduce trauma-related mortality and its complications. Objectives: Splint is a temporary and conventional method of fixing an injured organ. Therefore, evaluating the quality of life in trauma patients with splint immobilization is important. Methods: This prospective study was performed on 287 trauma patients with splint immobilization in two baseline periods and one month later in Haft-e-Tir and Rasoul-e-Akram hospitals. The Data collection tool was the SF-36 quality of life questionnaire. Paired t-test was used to assess the changes in the quality of life. SPSS version 21 was used for statistical analysis. Results: The mean quality of life in the study's first phase was 76.31 ± 9.42, and one month after splint immobilization was 76.13 ± 8.98, and there was no significant difference between the two phases. The Splint immobilization of the patients significantly affected the quality of life in 5 out of 8 dimensions. Still, the intervention increased the scores in 3 dimensions and decreased scores in 2 dimensions. The results showed that social performance (P = 0.01), energy and vitality (P < 0.001), and emotional health (P < 0.001) increased, and physical performance (P = 0.01) and general health (P = 0.001) decreased, and they were significantly different in the two phases. There were no significant differences between emotional limitation, physical limitation, and pain in the two phases of the study. Conclusions: Splint immobilization of patients improved the quality of life in 5 out of 8 dimensions. After a month, the trauma-related mental and physical shock did not disappear, and even the patients were more sensitive to quality-of-life questions due to time spent with splint immobilization and familiarity with its limitations. The patients tried to reflect on their dissatisfaction with splint immobilization.
背景:不同的国家采用不同的方法来降低创伤相关死亡率及其并发症。目的:夹板是一种临时的、常规的固定器官损伤的方法。因此,评估夹板固定的创伤患者的生活质量是很重要的。方法:本前瞻性研究对Haft-e-Tir和Rasoul-e-Akram医院的287例创伤患者进行了两个基线期和一个月后的夹板固定。数据收集工具为SF-36生活质量问卷。采用配对t检验评估生活质量的变化。采用SPSS version 21进行统计分析。结果:研究一期患者平均生活质量为76.31±9.42,固定夹板1个月后平均生活质量为76.13±8.98,两期差异无统计学意义。患者的夹板固定在8个维度中的5个维度显著影响生活质量。干预提高了3个维度的得分,降低了2个维度的得分。结果表明:社会绩效(P = 0.01)、精力活力(P < 0.001)和情绪健康(P < 0.001)提高,身体绩效(P = 0.01)和总体健康(P = 0.001)降低,且在两个阶段存在显著差异。在两个阶段的研究中,情绪限制、身体限制和疼痛之间没有显著差异。结论:固定夹板可改善患者8个维度中的5个维度的生活质量。一个月后,创伤相关的精神和身体休克并没有消失,甚至患者对生活质量问题也更加敏感,因为他们使用夹板固定的时间更长,并且熟悉其局限性。患者试图反思他们对夹板固定的不满。
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引用次数: 0
Road Traffic Accidents of Undocumented Immigrants Crossing Southeast Borders of Iran 穿越伊朗东南边境的无证移民的道路交通事故
Q3 Medicine Pub Date : 2023-08-09 DOI: 10.5812/semj-138162
M. Khammarnia, F. Setoodehzadeh
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引用次数: 0
Correlation Between Anxiety Disorders and Asthma Severity Indices in Asthmatic Children 哮喘患儿焦虑障碍与哮喘严重程度指标的相关性研究
Q3 Medicine Pub Date : 2023-08-01 DOI: 10.5812/semj-130199
Mahsa Rekabi, Parisa Honarpisheh, M. Karimi-Galougahi, V. Rekabi, Maryam Vasheghani, N. Eslami, S. Sharafian, Hooman Sharifi, A. Mahdaviani, M. Mansouri, Sasan Vasegh, A. Shirvani, Paniz Pourpashang
Background: Anxiety and depression in patients with asthma have been linked to frequent exacerbations, increased use of healthcare resources, and poor asthma control. Objectives: In the current study, we examined the correlations between asthma and symptoms of depression/anxiety in adolescents with asthma referred to Masih Daneshvari and Mofid hospitals during 2020 - 2021. Methods: The current observational, cross-sectional study was conducted by administering the Spence Children Anxiety Scale and a demographic information checklist among 105 subjects. Asthma severity was measured using forced expiratory volume in 1 second (FEV1), FEV1/forced vital capacity (FVC), the number of short-acting β-2 agonists used per week or month, the number of night awakenings per week or month, having asthma symptoms in daily activities, the number of asthma attacks needing oral corticosteroids per year, and the number of disease exacerbations per week or month. Data were analyzed, and the correlation between the variables was investigated through linear regression and ordinal logistic regression. Results: Patients with a mean age of 11.3 ± 2.5 years showed a mean overall anxiety score of 14 ± 9 out of 114. There was a significant negative correlation between the overall score of anxiety disorders and FEV1 and FEV1/FVC (P < 0.001). There was also a direct correlation between the overall score of anxiety disorders and the frequency of using β-2 agonists, the number of night awakenings, interference with normal functions, and exacerbation frequency (P < 0.001). Conclusions: Our findings indicated a significant association between anxiety disorders and asthma in children. Considering the high prevalence of asthma in Iran than the global average, studying the underlying mechanisms of anxiety and psychological and environmental variables in children with asthma can aid in developing effective psychological therapies.
背景:哮喘患者的焦虑和抑郁与频繁加重、医疗资源使用增加和哮喘控制不良有关。目的:在目前的研究中,我们研究了2020 - 2021年期间Masih Daneshvari和Mofid医院转诊的哮喘青少年哮喘与抑郁/焦虑症状之间的相关性。方法:采用Spence儿童焦虑量表和人口统计信息表对105名被试进行观察性横断面研究。通过1秒用力呼气量(FEV1)、FEV1/用力肺活量(FVC)、每周或每月使用的短效β-2激动剂的数量、每周或每月夜间醒来的次数、日常活动中出现哮喘症状的次数、每年需要口服皮质类固醇的哮喘发作次数以及每周或每月疾病加重的次数来测量哮喘严重程度。对数据进行分析,并通过线性回归和有序逻辑回归研究变量之间的相关性。结果:平均年龄11.3±2.5岁的患者平均焦虑总分为14±9分(总分114分)。焦虑障碍总分与FEV1、FEV1/FVC呈显著负相关(P < 0.001)。焦虑障碍总分与β-2激动剂使用频率、夜醒次数、正常功能受干扰程度、加重频率也存在直接相关(P < 0.001)。结论:我们的研究结果表明儿童焦虑障碍和哮喘之间存在显著关联。考虑到伊朗的哮喘患病率高于全球平均水平,研究哮喘儿童焦虑以及心理和环境变量的潜在机制有助于开发有效的心理治疗方法。
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引用次数: 0
Abnormal Innervation of the Arm Muscles by the Median Nerve: A Case Report 上肢肌肉受正中神经支配异常1例
Q3 Medicine Pub Date : 2023-07-30 DOI: 10.5812/semj-134642
M. E. Astaneh, Fatemeh Rezaei-Tazangi, Mohammad Reza Astaneh
Introduction: Brachial plexus variations have been observed in some people. The median nerve is one of the branches of this plexus, formed by the union of the medial and lateral cords. The median nerve usually does not have a branch in the arm region and innervates the forearm and hand muscles. Case Presentation: During the dissection of the right axillary cavity of a 74-year-old male donor for medical students, the variation in the innervation of arm muscles was observed. Unexpectedly, the biceps brachii and brachialis muscles were innervated by the branches of the median nerve. The median nerve normally does not have a branch in the arm region and innervates the forearm and hand muscles. The musculocutaneous nerve (C5-7) is a terminal branch of the lateral cord and innervates the three muscles of the anterior compartment of the arm, namely coracobrachialis, biceps brachii, and brachialis muscles. Conclusions: The innervation of the arm's anterior compartment muscles by the median nerve is a rare variation that has never been seen in this country. Awareness of such anatomical variations is necessary for physicians and clinicians. These variations should be taken into consideration during axillary region surgeries.
简介:在一些人身上观察到臂丛神经变异。正中神经是神经丛的一个分支,由内侧束和外侧束结合而成。正中神经通常在手臂区域没有分支,支配前臂和手部肌肉。病例介绍:在解剖74岁男医学生右腋窝时,观察到手臂肌肉神经支配的变化。出乎意料的是,肱二头肌和肱肌是由正中神经分支支配的。正中神经通常在手臂区域没有分支,支配前臂和手部肌肉。肌皮神经(C5-7)是外侧索的末梢分支,支配臂前室的3块肌肉,即肱喙肌、肱二头肌和肱肌。结论:上肢前腔室肌受正中神经支配是一种罕见的变异,在我国从未见过。意识到这种解剖变异是必要的医生和临床医生。在腋区手术时应考虑到这些变化。
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引用次数: 0
Digital Cognitive Tests for Dementia Screening: A Systematic Review
Q3 Medicine Pub Date : 2023-07-23 DOI: 10.5812/semj-137241
M. Amanzadeh, M. Hamedan, A. Mohammadnia, Abdollah Mahdavi
Context: The number of people with dementia is increasing dramatically. With the outbreak of the COVID-19 pandemic, digital screening tests can play a significant role in the remote and timely detection of people with dementia. This study aimed to review digital cognitive tests for dementia screening. Methods: We searched Web of Science, ProQuest, PubMed, Scopus, and Cochrane using related terms such as “dementia,” “mobile,” “digital,” “computer,” and “cognitive assessment,” leading to the emergence of 1,348 articles. Titles, abstracts, and full texts were screened to select the relevant articles based on inclusion/exclusion criteria. Study characteristics and digital test features such as diagnostic performance and deploying platforms were extracted from selected articles. The risk of bias and reporting quality were evaluated in the included studies. Results: Out of 1,348 identified articles, 32 were eligible for inclusion. We categorized digital cognitive tests into 3 groups based on deploying platforms: 1) Mobile-based screening tests (59.5%), 2) desktop-based screening tests (28%), and 3) web-based screening tests (12.5%). Conclusions: Digital cognitive tests, especially mobile-based screening tests, facilitate the timely diagnosis of dementia. The development of AI-based screening tests and the use of technologies such as virtual reality and chatbots will set a bright future in the early detection of dementia.
背景:痴呆症患者的数量正在急剧增加。随着COVID-19大流行的爆发,数字筛查测试可以在远程和及时发现痴呆症患者方面发挥重要作用。这项研究旨在回顾用于痴呆症筛查的数字认知测试。方法:我们搜索Web of Science, ProQuest, PubMed, Scopus和Cochrane,使用相关术语,如“痴呆”,“移动”,“数字”,“计算机”和“认知评估”,导致出现1348篇文章。对标题、摘要和全文进行筛选,根据纳入/排除标准选择相关文章。从选定的文章中提取研究特征和数字测试特征,如诊断性能和部署平台。在纳入的研究中评估偏倚风险和报告质量。结果:在鉴定的1348篇文章中,32篇符合纳入条件。我们根据部署平台将数字认知测试分为3组:1)基于手机的筛选测试(59.5%),2)基于桌面的筛选测试(28%),3)基于网络的筛选测试(12.5%)。结论:数字认知测试,特别是基于移动的筛查测试,有助于及时诊断痴呆症。基于人工智能的筛查测试的发展,以及虚拟现实和聊天机器人等技术的使用,将为痴呆症的早期检测创造一个光明的未来。
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引用次数: 0
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