BMJ Innovations最新文献_第8页

Future developments and new technologies in the field of faecal incontinence: scanning the horizon using late-stage clinical trial registrations 大便失禁领域的未来发展和新技术:使用后期临床试验注册扫描地平线

IF 2 Q3 HEALTH CARE SCIENCES & SERVICES

BMJ Innovations

Pub Date : 2022-04-22 DOI: 10.1136/bmjinnov-2021-000860

K. Thomson, K. Dangova, D. Bliss, S. Wallace, Nicole O’Connor, H. Richter, F. Pearson

Aim The aim of this study was to examine how new technologies in late-stage clinical trials might address unmet patient, practitioner or caregiver need for faecal incontinence (FI) over the next 5 years. Methods Horizon scanning techniques were used to provide insights into the current landscape of emerging health technologies. A search was performed across clinical trial registries using the National Institute for Health Research Innovation Observatory’s ScanMedicine database (scanmedicine.com) to identify new, emerging interventions or health technologies (drugs, medical devices or diagnostics) that were addressing or investigating FI. Trials were then screened for relevance to FI in a non-blinded duplicate manner. Results 1163 records were identified through searching ScanMedicine, and 136 trials were included in the final data extraction and mapping process. The most frequently investigated FI intervention topics were complementary therapies (n=17, 12.4%); electrical stimulation (n=13, 9.5%); pelvic floor muscle training/biofeedback/sphincter exercises (n=13, 9.5%) and implanted sacral nerve stimulation (n=12, 8.7%). There was little evidence of new pharmaceutical technologies in development. Existing drugs are, however, being repurposed and trialled for the treatment of FI (eg, linaclotide, colesevelam). Such repurposed drugs often have lower development costs, shorter timelines and report lower failure rates compared with new pharmaceutical products. Conclusion Overall, the innovation space as indicated by late-stage clinical trials related to FI, is relatively stagnant. Patients, carers and healthcare professionals are demanding more effective treatment and containment options; however, these are unlikely to come to market in the immediate future.

本研究的目的是研究晚期临床试验中的新技术如何在未来5年内解决未满足的患者、医生或护理人员对大便失禁(FI)的需求。方法利用水平扫描技术对新兴卫生技术的现状进行分析。使用国家卫生研究创新观察站的扫描医学数据库(scanmedicine.com)对临床试验注册进行了搜索，以确定正在解决或调查FI的新的新兴干预措施或卫生技术(药物，医疗设备或诊断)。然后以非盲法重复的方式筛选试验与FI的相关性。结果通过扫描医学检索共检索到1163条记录，其中136项试验进入了最终的数据提取和制图过程。最常被调查的FI干预主题是补充疗法(n=17, 12.4%);电刺激(n=13, 9.5%);盆底肌肉训练/生物反馈/括约肌训练(n=13, 9.5%)和植入式骶神经刺激(n=12, 8.7%)。几乎没有证据表明正在开发新的制药技术。然而，现有的药物正在被重新利用和试验用于治疗FI(例如，利那洛肽，colesvelam)。与新药品相比，这种重新利用的药物通常具有更低的开发成本、更短的时间和更低的失败率。总体而言，FI相关的后期临床试验显示，创新空间相对停滞。患者、护理人员和卫生保健专业人员要求更有效的治疗和遏制方案;然而，这些产品不太可能在近期上市。

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引用次数: 1

’Padayon’: a new digital health model for diabetes and hypertension in rural Philippines “Padayon”:菲律宾农村糖尿病和高血压的新数字健康模式

IF 2 Q3 HEALTH CARE SCIENCES & SERVICES

BMJ Innovations

Pub Date : 2022-04-20 DOI: 10.1136/bmjinnov-2021-000900

John Paluyo, Anne Stake, Richard L. Bryson

© Author(s) (or their employer(s)) 2022. Reuse permitted under CC BYNC. No commercial reuse. See rights and permissions. Published by BMJ. INTRODUCTION Noncommunicable diseases (NCDs) account for 41 million global deaths every year, equating to 71% of global deaths overall. Of the 41 million deaths, 29 million occur in lowincome and middleincome countries (LMICs). However, health system services for prevention, education, screening and treatment of NCDs remain inaccessible to billions of people living in rural regions in LMICs. The WHO has reported that over half the world’s population lack access to the basic health services they need. Digital health has the potential to address the gaps and weaknesses of traditional health systems. Unfortunately, many digital health services do not work in regions with low internet connectivity and low digital literacy. Approximately 3 billion people lack internet connectivity at all. The growth in virtual healthcare during the COVID19 pandemic has been primarily in affluent, metropolitan areas. Digital health needs to better serve the lowincome, rural populations at risk of NCDs. A new digital health model, Padayon, for diabetes and hypertension was designed to address this challenge across LMICs. The focus was the municipality of Pototan, Western Visayas, in rural Philippines. The prevalence of type 2 diabetes among adults in the Philippines is estimated at 7%, comprising almost 4 million cases and accounting for 6.5% of mortality across total deaths in 2020. Cardiovascular disease is the single largest cause of mortality in the Philippines, accounting for 33% of total deaths. There are significant health system weaknesses in Pototan, where residents live on an average income of $3–7 per day and over an hour from healthcare providers. There is a lack of access to basic screening such as random blood sugar (RBS) testing, with a comprehensive panel for diabetes at a private clinic costing 10 times the residents’ daily wage. Residents must travel over an hour Summary box

©作者(或其雇主)2022。在CC BYNC下允许重用。禁止商业重用。请参阅权利和权限。英国医学杂志出版。全球每年有4100万人死于非传染性疾病，相当于全球总死亡人数的71%。在4100万例死亡中，有2900万例发生在低收入和中等收入国家。然而，生活在中低收入国家农村地区的数十亿人仍然无法获得卫生系统预防、教育、筛查和治疗非传染性疾病的服务。世界卫生组织报告称，世界上一半以上的人口无法获得他们所需的基本卫生服务。数字卫生有潜力解决传统卫生系统的差距和弱点。不幸的是，许多数字卫生服务在互联网连通性低和数字识字率低的地区无法发挥作用。大约有30亿人完全没有互联网连接。在covid - 19大流行期间，虚拟医疗保健的增长主要发生在富裕的大都市地区。数字卫生需要更好地为面临非传染性疾病风险的低收入农村人口服务。针对糖尿病和高血压的新型数字健康模式Padayon旨在应对中低收入国家的这一挑战。重点是菲律宾农村的西米沙鄢群岛的波托坦市。菲律宾成年人中2型糖尿病的患病率估计为7%，包括近400万例，占2020年总死亡人数的6.5%。心血管疾病是菲律宾最大的死亡原因，占总死亡人数的33%。波托坦的卫生系统存在严重缺陷，当地居民每天的平均收入为3-7美元，从医疗服务提供者那里获得的时间超过一小时。缺乏基本的筛查，如随机血糖(RBS)测试，在一家私人诊所进行全面的糖尿病检查，费用是居民日薪的10倍。居民旅行时间必须超过1小时

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引用次数: 1

Road to success: lessons from the Qatar Foundation Ability Friendly Program 成功之路:卡塔尔基金会能力友好计划的经验教训

IF 2 Q3 HEALTH CARE SCIENCES & SERVICES

BMJ Innovations

Pub Date : 2022-04-20 DOI: 10.1136/bmjinnov-2021-000928

Maha El Akoum, Neil Moors, Diedre Thompson, Ryan Moignard, Kathleen Bates

© Author(s) (or their employer(s)) 2022. Reuse permitted under CC BYNC. No commercial reuse. See rights and permissions. Published by BMJ. INTRODUCTION: QATAR FOUNDATION’S ABILITY FRIENDLY (AF) PROGRAM History and evolution of the programme Although the AF sports programme was not officially launched in Qatar until 2019, the planning process for the development and inauguration of the programme was set in motion much earlier. Three years earlier, in 2016, the World Innovation Summit for Health (WISH), an initiative of the Qatar Foundation for Education, Science, and Community Development (QF), published a global research report on autism titled ‘Autism: a Global Framework for Action’. This report formed one of a series of reports published during the WISH 2016 summit, and 1 of 50 WISH has produced since its inception in 2013. Publication of the autism report also coincided with a powerful grassroots campaign from a group of mothers in Qatar who were collectively calling for greater inclusion opportunities for their children. The idea for a programme that would provide a unique opportunity for inclusive sports, leisure and social opportunities for children and young adults with autism came directly from the recommendations of the WISH report. For the vast majority of WISH research reports, it falls to national and regional governments, along with other care providers, to implement and take forward report recommendations. While the Qatari government set about creating an overarching national autism strategy at the national level—taking many of the recommendations from the 2016 report—the WISH team saw an opportunity to use its parent organisation, QF, as a platform to lead the introduction of abilityfriendly programmes within the community. Physical activity (PA) and participation in recreational and competitive sports in general have long been considered a positive Summary box

©作者(或其雇主)2022。在CC BYNC下允许重用。禁止商业重用。请参阅权利和权限。英国医学杂志出版。简介:卡塔尔基金会的能力友好(AF)项目的历史和发展尽管AF体育项目直到2019年才在卡塔尔正式启动，但该项目的发展和启动的规划过程早在很久以前就开始了。三年前，即2016年，卡塔尔教育、科学和社区发展基金会发起的世界卫生创新峰会(WISH)发表了一份关于自闭症的全球研究报告，题为《自闭症:全球行动框架》。本报告是WISH 2016峰会期间发布的一系列报告之一，也是WISH自2013年成立以来发布的50份报告中的一份。自闭症报告的发表也恰逢卡塔尔一群母亲发起了一场强有力的基层运动，她们集体呼吁为自己的孩子提供更多的包容机会。为患有自闭症的儿童和青年提供包容性运动、休闲和社交机会的独特机会方案的想法直接来自世界自闭症愿望报告的建议。对于绝大多数WISH研究报告而言，落实和推进报告建议的任务落在了国家和地区政府以及其他保健提供者的肩上。卡塔尔政府着手在国家层面制定一项国家孤独症总体战略，采纳了2016年报告中的许多建议。与此同时，WISH团队看到了一个机会，利用其母组织QF作为一个平台，领导在社区内引入有利于能力的规划。体育活动(PA)和参与娱乐和竞技体育一直被认为是一个积极的总结框

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引用次数: 0

Real-time continuous measurement of lactate through a minimally invasive microneedle patch: a phase I clinical study. 通过微创微针贴片实时连续测量乳酸：一项I期临床研究。

IF 1.8 Q3 HEALTH CARE SCIENCES & SERVICES

BMJ Innovations

Pub Date : 2022-04-01 Epub Date: 2022-02-28 DOI: 10.1136/bmjinnov-2021-000864

Damien K Ming, Saylee Jangam, Sally An Gowers, Richard Wilson, David Me Freeman, Martyn G Boutelle, Anthony Eg Cass, Danny O'Hare, Alison H Holmes

Introduction: Determination of blood lactate levels supports decision-making in a range of medical conditions. Invasive blood-sampling and laboratory access are often required, and measurements provide a static profile at each instance. We conducted a phase I clinical study validating performance of a microneedle patch for minimally invasive, continuous lactate measurement in healthy volunteers.

Methods: Five healthy adult participants wore a solid microneedle biosensor patch on their forearms and undertook aerobic exercise for 30 min. The microneedle biosensor quantifies lactate concentrations in interstitial fluid within the dermis continuously and in real-time. Outputs were captured as sensor current and compared with lactate concentrations from venous blood and microdialysis.

Results: The biosensor was well-tolerated. Participants generated a median peak venous lactate of 9.25 mmol/L (IQR 6.73-10.71).Microdialysate concentrations of lactate closely correlated with blood. Microneedle biosensor current followed venous lactate concentrations and dynamics, with good agreement seen in all participants. There was an estimated lag-time of 5 min (IQR -4 to 11 min) between microneedle and blood lactate measurements.

Conclusion: This study provides first-in-human data on use of a minimally invasive microneedle patch for continuous lactate measurement, providing dynamic monitoring. This low-cost platform offers distinct advantages to frequent blood sampling in a wide range of clinical settings, especially where access to laboratory services is limited or blood sampling is infeasible. Implementation of this technology in healthcare settings could support personalised decision-making in a variety of hospital and community settings.

Trial registration number: NCT04238611.

简介：测定血乳酸水平支持在一系列医疗条件下的决策。通常需要侵入性血液采样和实验室访问，并且在每个实例中测量提供静态轮廓。我们进行了一项I期临床研究，验证了微针贴片在健康志愿者中用于微创、连续乳酸测量的性能。方法：5名健康成人受试者在前臂佩戴固体微针生物传感器贴片，进行30分钟的有氧运动。微针生物传感器可以连续实时地定量测定真皮间质液中的乳酸浓度。输出作为传感器电流捕获，并与静脉血和微透析的乳酸浓度进行比较。结果：该生物传感器耐受性良好。参与者静脉乳酸的中位峰值为9.25 mmol/L （IQR为6.73-10.71）。微透析液乳酸浓度与血液密切相关。微针生物传感器电流跟踪静脉乳酸浓度和动态，在所有参与者中都有很好的一致性。在微针和血乳酸测量之间估计有5分钟的滞后时间（IQR -4到11分钟）。结论：本研究首次提供了使用微创微针贴片进行连续乳酸测量的人体数据，提供了动态监测。这种低成本平台为在广泛的临床环境中进行频繁的血液采样提供了明显的优势，特别是在获得实验室服务有限或无法进行血液采样的情况下。在医疗保健环境中实施这项技术可以支持各种医院和社区环境中的个性化决策。试验注册号：NCT04238611。

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引用次数: 0

Healthcare’s new frontier: the digital front door 医疗保健的新前沿:数字前门

IF 2 Q3 HEALTH CARE SCIENCES & SERVICES

BMJ Innovations

Pub Date : 2022-03-15 DOI: 10.1136/bmjinnov-2021-000874

Namrata Rastogi

Primary care has faced long-standing access challenges in the UK National Health Service (NHS) due to an increased demand on services caused by an ageing population, inadequate funding, a shortage of General Practitioners (GPs) and GP trainees and inefficient administrative processes. The pandemic accelerated digital adoption in primary care as policy and reimbursement changes led to new ways of working including telephone triage, video consultations, remote monitoring, online consultations, and text and email communication between clinicians and patients. The agenda has moved to how innovation teams lead digital transformation to drive long term and sustainable benefits in primary care. The digital front door is defined as the channels and framework through which patients access network-wide services in a digitally enabled system. Pillars to this front door include navigation, triage, increased electronic health record (EHR) functionality, shared care records with interoperability, a skilled workforce, key stakeholder engagement and digital inclusion. Out of hospital care has become an integrated community of health, wellness and social care providers. Primary care organisations are presented with a unique opportunity to redesign their access points, to re-evaluate how to navigate and triage users most effectively through their systems, to leverage health data and analytics to derive more insights from the EHR than ever before, and to build a skilled workforce that meets the evolving needs of the community as we move towards a more equitable health system.

由于人口老龄化、资金不足、全科医生(GP)和全科医生培训生短缺以及行政流程效率低下，对服务的需求不断增加，英国国家卫生服务体系(NHS)的初级保健面临着长期存在的挑战。由于政策和报销方式的变化导致了新的工作方式，包括电话分诊、视频会诊、远程监测、在线会诊以及临床医生与患者之间的文本和电子邮件通信，大流行加速了初级保健领域的数字化采用。议程已转向创新团队如何领导数字化转型，以推动初级保健的长期和可持续效益。数字前门被定义为患者在数字启用系统中访问全网服务的渠道和框架。这扇大门的支柱包括导航、分类、增强的电子健康记录(EHR)功能、具有互操作性的共享护理记录、熟练的员工队伍、关键利益相关者的参与和数字包容。院外护理已成为保健、保健和社会护理提供者的综合社区。初级保健组织面临着一个独特的机会，可以重新设计他们的接入点，重新评估如何通过他们的系统最有效地导航和分类用户，利用卫生数据和分析从电子病历中获得比以往更多的见解，并在我们朝着更公平的卫生系统迈进的过程中建立一支满足社区不断变化的需求的熟练劳动力队伍。

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引用次数: 0

Ambulatory monitoring of patients with COVID-19: initial experiences and next steps COVID-19患者的动态监测:初步经验和后续步骤

IF 2 Q3 HEALTH CARE SCIENCES & SERVICES

BMJ Innovations

Pub Date : 2022-02-28 DOI: 10.1136/bmjinnov-2021-000875

S. Connolly, H. Wa Katolo, C. Cronin, Alison Dingle, M. Creed, C. Edwards, K. O'Reilly, Brendan O'Kelly, J. Lambert, E. Muldoon, G. Sheehan, H. Coetzee, Alan Sharp, S. Dempsey, E. O'Connor, J. Farrell, A. Cotter, T. McGinty

© Author(s) (or their employer(s)) 2022. No commercial reuse. See rights and permissions. Published by BMJ. INTRODUCTION Since cases were first described in December 2019, SARSCoV2 has posed a distinct challenge to healthcare delivery, and Ireland has been no exception. Hospital bed numbers per capita in Ireland are at 2.9 per 1000 inhabitants, bed occupancy is the highest in the European Union, care is predominantly delivered in 4 to 6bedded wards, and singleroom isolation facilities are in short supply, risking being overwhelmed by high caseloads. Droplet spread within environments increasingly appears to travel further than the initially predicted 2 m 3 and one Irish hospital has reported as many as 49% of their COVID19 cases occurring via nosocomial transmission, and higher (32%) mortality in this group. We therefore identified a need to manage patients safely at home to minimise spread to susceptible patients and staff. As SARSCoV2 infection’s natural history includes a rapid deterioration, characteristically in the second week of the illness in those who develop severe disease, 6 the challenge of safely caring for such patients in the community was raised. Given that COVID19 causes pneumonitis and impaired oxygenation, it is advised that patients with mildmoderate COVID19 are monitored for progression. Finger probe oxygen saturation (SpO 2 ) monitoring is therefore a feasible method of home monitoring. Within months of the pandemic being declared a number of centres internationally (including those within Australia, Canada, China, The Netherlands and the UK) began to implement COVID19 virtual monitoring programmes, taking a variety of forms, ranging from telephone support alone to remote assessments of patients’ symptoms in combination with collecting biometric data. Ireland’s national Health Service Executive (HSE) developed an early partnership with the digital health firm patientMpower in February 2020, with rollout of a new Summary box

©作者(或其雇主)2022。禁止商业重用。请参阅权利和权限。英国医学杂志出版。自2019年12月首次发现病例以来，SARSCoV2对医疗服务构成了明显的挑战，爱尔兰也不例外。爱尔兰的人均医院床位数量为每1000名居民2.9张，床位占用率在欧洲联盟中最高，主要在4至6张床位的病房提供护理，单间隔离设施供应不足，有可能因大量病例而不堪重负。环境中的飞沫传播似乎越来越多地比最初预测的2立方米传播得更远，一家爱尔兰医院报告了多达49%的covid - 19病例是通过医院传播发生的，这一群体的死亡率更高(32%)。因此，我们确定需要在家中对患者进行安全管理，以尽量减少对易感患者和工作人员的传播。由于SARSCoV2感染的自然史包括迅速恶化，特别是在病情发展为严重疾病的患者在发病的第二周，因此提出了在社区中安全护理这类患者的挑战。鉴于covid - 19会导致肺炎和氧合受损，建议监测轻中度covid - 19患者的病情进展。因此，手指探针血氧饱和度(SpO 2)监测是一种可行的家庭监测方法。在宣布大流行的几个月内，国际上的一些中心(包括澳大利亚、加拿大、中国、荷兰和英国境内的中心)开始实施covid - 19虚拟监测方案，采取多种形式，从单独的电话支持到结合收集生物特征数据对患者症状进行远程评估。2020年2月，爱尔兰国家卫生服务管理局(HSE)与数字健康公司patientMpower建立了早期合作伙伴关系，推出了一个新的摘要框

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引用次数: 3

Collaborative, patient-centred care model that provides tech-enabled treatment of opioid use disorder via telehealth 协作、以患者为中心的护理模式，通过远程保健提供阿片类药物使用障碍的技术支持治疗

IF 2 Q3 HEALTH CARE SCIENCES & SERVICES

BMJ Innovations

Pub Date : 2022-02-24 DOI: 10.1136/bmjinnov-2021-000816

R. Rollston, Winifred Gallogly, Liza Hoffman, Eshan Tewari, Sarah Powers, Brian Clear

Rollston R, et al. BMJ Innov 2022;0:1–6. doi:10.1136/bmjinnov-2021-000816 Research & Development, Bicycle Health Inc, Boston, Massachusetts, USA Patient Services, Bicycle Health Inc, Boston, Massachusetts, USA User Experience Research, Bicycle Health Inc, Boston, Massachusetts, USA Product, Bicycle Health Inc, Boston, Massachusetts, USA Clinical Medicine, Bicycle Health Inc, Boston, Massachusetts, USA

罗尔斯顿R，等。中国生物医学工程学报(英文版);2008;01 - 01。研究与开发，自行车健康公司，波士顿，马萨诸塞州，美国患者服务，自行车健康公司，波士顿，马萨诸塞州，美国用户体验研究，自行车健康公司，波士顿，马萨诸塞州，美国产品，自行车健康公司，波士顿，马萨诸塞州，美国临床医学，自行车健康公司，波士顿，马萨诸塞州，美国

引用次数: 3

Measuring the learning outcomes of datathons 测量数据马拉松的学习成果

IF 2 Q3 HEALTH CARE SCIENCES & SERVICES

BMJ Innovations

Pub Date : 2022-02-17 DOI: 10.1136/bmjinnov-2021-000747

M. Lyndon, Atipong Pathanasethpong, M. Henning, Yan Chen, L. Celi

Purpose Healthcare datathons are events in which cross-disciplinary teams leverage data science methodologies to address clinical questions using large datasets. The aim of this research was to evaluate participant satisfaction and learning outcomes of datathons. Methods A multicentre cross-sectional study was performed using survey data from datathons conducted in Sydney, Australia (April 2018) n=98, Singapore (July 2018) n=169 and Beijing, China (December 2018) n=200. Participants (n=467) completed an online confidential survey at the end of the datathons which contained the Affective Learning Scale, and measures of event satisfaction, perceived knowledge gain, as well as free text responses, and participants’ demographic background. Data analysis used descriptive statistics and multivariate analysis of variance (MANOVA). Thematic analysis was performed on the text responses. Results The overall response rate was 64% (301/467). Participants were mostly male (70%); 50.2% were health professionals and 49.8% were data scientists. Based on the Affective Learning Scale (7-point Likert type scale), participants reported a positive learning experience (M = 5.93, SD = 1.21), satisfaction for content and subject matter of the datathon (M = 5.81, SD = 1.17), applying behaviours (M = 4.71, SD =2.02), instruction from mentors (M = 6.01, SD = 1.18), and intention to participate in future datathons (M = 6.03, SD = 1.23). The MANOVA showed significant differences between health professionals and data scientists in perceived knowledge gain from the datathons. Themes from text responses emerged: (1) cross-disciplinary collaboration; (2) improving healthcare using data science and (3) preparations for big data analytics. Conclusions Datathons provide a satisfying learning experience for participants and promote affective learning, cross-disciplinary collaboration and knowledge gain in health data science.

医疗保健数据马拉松是跨学科团队利用数据科学方法使用大型数据集解决临床问题的活动。本研究的目的是评估数据马拉松的参与者满意度和学习成果。方法采用澳大利亚悉尼(2018年4月)(n=98)、新加坡(2018年7月)(n=169)和中国北京(2018年12月)(n=200)数据马拉松的调查数据进行多中心横断面研究。参与者(n=467)在数据马拉松结束时完成了一项在线保密调查，其中包括情感学习量表、事件满意度、感知知识获得、自由文本回复和参与者的人口统计学背景。数据分析采用描述性统计和多变量方差分析(MANOVA)。对文本回复进行主题分析。结果总有效率为64%(301/467)。参与者以男性居多(70%);50.2%是卫生专业人员，49.8%是数据科学家。基于情感学习量表(7点Likert型量表)，参与者报告了积极的学习体验(M = 5.93, SD = 1.21)，对数据马拉松的内容和主题的满意度(M = 5.81, SD = 1.17)，应用行为(M = 4.71, SD =2.02)，导师指导(M = 6.01, SD = 1.18)和参与未来数据马拉松的意愿(M = 6.03, SD = 1.23)。方差分析显示，卫生专业人员和数据科学家在从数据马拉松中获得的感知知识方面存在显著差异。从文本回复中可以得出以下主题:(1)跨学科合作;(2)利用数据科学改善医疗保健;(3)为大数据分析做准备。结论数据马拉松为参与者提供了满意的学习体验，促进了健康数据科学的情感学习、跨学科协作和知识获取。

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引用次数: 0

Barriers and facilitators to adopting horizon scanning to identify novel integrated care models: a qualitative interview study 采用水平扫描识别新型综合护理模式的障碍与促进因素:一项定性访谈研究

IF 2 Q3 HEALTH CARE SCIENCES & SERVICES

BMJ Innovations

Pub Date : 2022-02-16 DOI: 10.1136/bmjinnov-2021-000804

Malin Nuth Waggestad-Stoa, Gloria Traina, Eli Feiring

Objectives Horizon scanning methodologies are employed in healthcare to identify and prioritise innovations at the early stages of development processes. To date, horizon scanning has been predominantly applied to early awareness systems of health technologies to facilitate healthcare planning. Still, horizon scanning methodologies may also be relevant for identifying novel healthcare delivery models and interventions. This study aimed to examine perceptions of determinants for adopting horizon scanning in the context of the development of integrated care models. Methods Qualitative semistructured interviews were conducted between March and May 2021. The interviewees (n=10) were participants in innovation projects in the South-Eastern Norway Regional Health Authority. Data were analysed thematically with the aid of a predefined framework adapted from behavioural change theory. Results Determinants of adopting horizon scanning were reported at the individual, organisational and wider institutional levels. Seven domains were perceived to enable or hinder stakeholders’ potential use of horizon scanning: knowledge of structured reviews, skills to perform horizon scanning, beliefs about consequences (validity and reliability of information, outcomes of filtering and priority setting, stakeholder involvement), beliefs about capabilities (technical skills, knowledge of roles and professional identities, organisational regulations), emotions (positivity, engagement, change fatigue), organisational resources (professional library, time, management support), context (complexity of ‘integrated care’, professional hierarchies, legal and political regulations). Conclusions This study provides novel insights into potential determinants for adopting horizon scanning to identify, assess and prioritise innovative integrated care models. The findings may assist organisations considering using horizon scanning and inform strategies to mitigate barriers and promote facilitators.

目标水平扫描方法用于医疗保健，在发展过程的早期阶段识别和优先考虑创新。迄今为止，水平扫描已主要应用于卫生技术的早期意识系统，以促进卫生保健计划。尽管如此，水平扫描方法也可能与确定新的医疗服务模式和干预措施有关。本研究旨在探讨在综合护理模式发展的背景下，采用水平扫描的决定因素的看法。方法于2021年3月至5月进行定性半结构化访谈。受访者(n=10)是挪威东南部地区卫生局创新项目的参与者。在行为改变理论的预定义框架的帮助下，对数据进行了主题分析。结果在个人、组织和更广泛的机构层面报告了采用水平扫描的决定因素。七个领域被认为能够或阻碍利益相关者使用水平扫描:结构化审查的知识、水平扫描的技能、对结果的信念(信息的有效性和可靠性、过滤和优先级设置的结果、利益相关者的参与)、对能力的信念(技术技能、角色和职业身份的知识、组织法规)、情绪(积极性、参与度、变革疲劳)、组织资源(专业图书馆、时间、管理支持)、背景(“综合护理”的复杂性)、职业等级，法律和政治规定)。本研究为采用水平扫描来识别、评估和优先考虑创新综合护理模式的潜在决定因素提供了新的见解。研究结果可能有助于组织考虑使用水平扫描和通知策略，以减轻障碍和促进促进者。

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引用次数: 0

Virtual reality experience for in utero fetal surgery: a new era of patient counselling and medical education 子宫内胎儿手术的虚拟现实体验:患者咨询和医学教育的新时代

IF 2 Q3 HEALTH CARE SCIENCES & SERVICES

BMJ Innovations

Pub Date : 2022-01-18 DOI: 10.1136/bmjinnov-2021-000799

Y. Blumenfeld, David M. Axelrod, David Sarno, S. Hintz, K. Sylvester, Gerald A Grant, M. Belfort, A. Shamshirsaz, Y. El‐Sayed

Blumenfeld YJ, et al. BMJ Innov 2022;0:1–3. doi:10.1136/bmjinnov-2021-000799 Obstetrics & Gynecology, Stanford University School of Medicine, Stanford, California, USA Cardiology, Stanford University School of Medicine, Stanford, California, USA Lighthaus, Inc, San Francisco, California, USA Pediatrics, Stanford University School of Medicine, Stanford, California, USA Surgery, Stanford University School of Medicine, Stanford, California, USA Neurosurgery, Stanford University School of Medicine, Stanford, California, USA Obstetrics & Gynecology, Baylor College of Medicine, Houston, Texas, USA

Blumenfeld YJ，等。中国生物医学工程学报(英文版);2009;01:1 - 3。doi:10.1136/ bmjinnovi -2021-000799美国妇产科，斯坦福大学医学院，斯坦福大学，加州，美国心脏病学，斯坦福大学医学院，斯坦福，加州，旧金山，美国儿科，斯坦福大学医学院，斯坦福，加州，斯坦福大学医学院，美国外科，斯坦福大学医学院，斯坦福，加州，斯坦福，美国神经外科，斯坦福大学医学院，斯坦福，加州，斯坦福，美国妇产科，贝勒医学院，休斯顿，德克萨斯州，美国

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