HRB open research最新文献

Background: Since the late 1980s there's been a growing body of knowledge that applies behavioural and cognitive theories to understanding how people accept new technologies. However, a paradox exists between studies demonstrating the many benefits of Digital Systems in Healthcare and the volume of literature detailing end-user clinician acceptance issues. The problems encountered when designing, developing, and operating complex technologies are not limited to technical or engineering issues. Technology implemented in organizations does not stand alone but is part of a broader socio-technical system, spanning divergent groups of people, each with their own cultural dynamics and distinct ways of working. Paramedics have personality traits that may be advantageous in their career, but research is needed to determine how these affect their ability to accept new technologies.

Methods: This scoping review will be conducted according to Joanna Briggs Institute (JBI) guidelines has been registered with the Open Science Foundation (OSF). Electronic searches for relevant publications will be conducted in MEDLINE, PubMed, Scopus, CINHAL, IEEE, ACM, PsycINFO, Web of Science. Global English language literature related to digital acceptance in Emergency Medical Services after 2004 will be included.

Results: The process of extraction, analysis, and presentation will be conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR).

Conclusions: This scoping review will collect meta-data on Behavioural, Cognitive, and Environmental factors common to the dominant prevailing digital acceptance theories to determine if any would be effective in explaining the experience of implementing technology with Paramedics and Emergency Medical Technicians (EMTs) working in Emergency Medical Services.

Background: Cancer is a leading cause of mortality in Ireland, accounting for approximately 30% of deaths annually. Early diagnosis improves survival, reduces treatment burden, and enhances patient outcomes. Rapid Access Clinics (RACs) were introduced to facilitate expedited diagnosis of suspected lung, prostate, and breast cancers, as well as malignant melanoma. However, the extent to which Irish general practitioners (GPs) utilise RAC pathways, and the subsequent diagnostic outcomes, remain poorly understood.

Methods: This retrospective repeated cross-sectional study will analyse electronic health records from Irish general practices (2013-2024). Phase 1 will assess trends in RAC referrals, including volume, cancer type, and inter-practice variation, alongside demographic, geographic, and clinical factors influencing referral rates. Phase 2 will evaluate cancer conversion rates, time to diagnosis, stage at diagnosis, treatment received, and cancer-specific mortality. Data collection will use a validated extraction tool, and analysis will follow STROBE guidelines for observational studies.

Expected outcomes: This study will quantify RAC referral patterns and identify factors influencing variability in GP referral behaviour. It will also assess diagnostic yield and cancer outcomes associated with RAC referrals. Findings will inform quality improvement initiatives and policy development to optimise cancer diagnostic pathways in Ireland.

Background: Lung cancer is a significant cause of cancer-related mortality globally, with early detection through screening critical to improving patient outcomes. However, recruiting high-risk individuals, particularly in deprived populations, for screening remains a considerable challenge. This study aims to co-design a targeted recruitment strategy for lung cancer screening, tailored to the specific needs and experiences of high-risk individuals, in collaboration with a Patient and Public Involvement (PPI) panel and expert stakeholders in Ireland.

Methods: We will employ a mixed-methods design guided by the Medical Research Council (MRC) framework for developing complex interventions. Our approach will integrate systematic review findings on screening participation interventions, evaluation of the recruitment strategy's feasibility in an Irish context, and the application of behavioural science frameworks. The target population includes individuals aged 55-74 who reside in highly deprived areas and are at high risk of developing lung cancer based on the National Lung Screening Trial criteria, as well as those eligible for our Lung Health Check trial who met equivalent risk thresholds.

Conclusion: This co-designed recruitment strategy will combine evidence-based research, local context understanding, and stakeholder input to develop a solution that is both scientifically robust and tailored to the target population's needs. This patient-centred approach aims to increase the potential for successful implementation of lung cancer screening programs, thereby improving early detection and patient outcomes.

Background: Lung cancer (LC) is the leading cause of cancer death in Ireland, yet no national screening programme exists. While low-dose computed tomography (LDCT) screening reduces lung cancer mortality by approximately 20% in high-risk populations, its cost-effectiveness in Ireland remains uncertain. Evidence on the economic burden of lung cancer care and the feasibility of screening is needed to support policy decisions.

Aim: This research programme will evaluate the economic impact of lung cancer care in Ireland and assess the cost-effectiveness of LDCT screening. By integrating screening eligibility modelling, stage-specific cost analysis, and economic evaluation, the study aims to generate evidence to support resource allocation and policy development.

Methods: The programme consists of three interlinked work packages. First, screening eligibility will be estimated using a dynamic Markov model that integrates demographic data from the Central Statistics Office (CSO), population projections, and smoking history data from Eurobarometer. Second, a stage-specific cost analysis will be conducted using a discrete event simulation (DES) model informed by data from the National Cancer Registry Ireland (NCRI), the Healthcare Pricing Office (HPO), and other healthcare reimbursement sources. Third, a cost-effectiveness analysis will adapt a UK-based LC natural history model (updated ENaBL model 2022) to evaluate alternative screening strategies, incorporating Irish-specific costs, clinical outcomes, and quality-adjusted life-years (QALYs).

Results and implications: This programme will generate evidence to inform the design of a cost-effective LCS programme in Ireland. Findings will guide healthcare planning, optimise screening strategies, and support sustainable policy decisions.

Visceral Pain is a common debilitating symptom of inflammatory bowel disease (IBD) and irritable bowel syndrome (IBS). The endocannabinoid system (ECS) is a prime target for alleviation of visceral pain, given its important role in both gastrointestinal physiology and pain. We will conduct a systematic review of randomised controlled trials (RCTs) of cannabis, cannabinoids, cannabis-based medicines (CBMs), and other ECS modulators for patients with IBD and IBS, comparing any preparation of cannabis, any cannabinoid, CBM, or other pharmacological modulator of the ECS (any dose, by any route of administration), with any control (placebo, or pharmacological / psychological / dietary intervention). We will search CENTRAL, MEDLINE, PubMed, EMBASE, and Web of Science databases, as well as the WHO International Clinical Trials Registry Platform and ClinicalTrials.gov Trials Registries, together with reference checking and citation searching, following PRISMA guidelines. Our objectives are to evaluate the benefits and harms of pharmacological modulation of the ECS for visceral abdominal pain in patients with IBD or IBS, compared to placebo or other interventions. The primary outcomes will be the proportion of people with (a) at least a 30% reduction and (b) at least a 50% reduction in pain. Secondary outcomes will include any change in pain intensity, physical and emotional functioning, fatigue and sleep measures, quality of life, gastrointestinal disease or symptom severity, and adverse effects. We will assess risk of bias in the RCTs using the Cochrane Risk of Bias 2 tool. Where there are sufficient data that are directly comparable, we will conduct meta-analyses of the results for each outcome. We will use the GRADEpro GDT tool to assess certainty of evidence for each outcome. This review will synthesise the available evidence regarding all types of ECS modulation for the treatment of visceral abdominal pain and its related comorbidities in IBS and IBD patients.

Background: Ever-growing numbers of individuals are surviving stroke and living with the consequences. Life after stroke is a key pillar in addressing the burden of stroke for the remaining lifespan for those with stroke. No consensus on how to best promote agency and fulfilment in life after stroke or the resources required to achieve this currently exists.

Methods: In this realist review protocol we outline the methods we will use to gain an understanding of supporting Life after Stroke through the development of programme theories. These will consist of context-mechanism-outcome configurations (CMOCs) and will acknowledge the resources required. The review will follow the RAMESES five-stage structured methodology to (1) define the scope of the review, and the development of initial programme theories for supporting life after stroke, (2) develop a comprehensive search strategy to identify relevant research, (3) review primary studies and extract data, (4) synthesise evidence (5) refine programme theories iteratively throughout the process using an Expert Panel and reference group, to including stroke researchers, health care professionals working in stroke care, people with lived experience of stroke and carers, and stroke support agencies.

Conclusion: This realist review will examine the mechanisms and contexts for a supported life after stroke care pathway. The CMOCs developed will help explain how generative causation within the life after stroke pathway works. The findings will help inform policy and practice and inform future realist evaluations of Life after Stroke support pathways.

Background: Public and Patient Involvement (PPI) refers to the active collaboration of patients and the public in health and social care research decision-making, enhancing research success, cost-effectiveness, and impact. Children, young people, and their families bring unique lived experiences to PPI in research, relating to others with similar experiences, while factors like age, cognitive maturation, and developmental stage create differences between researchers and patients or the public. Collaboration with children, young people, and their families should be guided by specific project context and a strong evidence base. However, existing systematic reviews reveal inconsistencies in reporting and a lack of standardised methods for these groups, limiting effective PPI implementation. This protocol details methods for an umbrella review to identify the current state-of-science and future priorities for collaborating with children, young people and families in health and social care research.

Methods: The protocol was developed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA-P) guidelines, which will also direct the reporting of findings. The Joanna Briggs Institute's methodology for conducting umbrella reviews will be adhered to throughout. MEDLINE, CINAHL, EMBASE, PsycINFO, Cochrane, DARE, JBI Evidence Synthesis, PROSPERO, grey literature databases, targeted international networks, and the Google search engine will be searched for systematic reviews on PPI with children, young people, and families in health and social care research. Two reviewers will independently conduct eligibility screening, data extraction, and quality appraisal.

Conclusions: This umbrella review will provide critical insights into the state-of-science of PPI with children, young people and families in health and social care research. The synthesis of findings could yield important information for researchers and other stakeholders conducting health and social care research in collaboration with children, young people and families by highlighting key patterns, gaps, and recommendations to guide future PPI practices, policies, and research.

Registration: This umbrella review was registered in PROSPERO, the International Prospective Register of Systematic Reviews (Prospero registration number: CRD42024608935, registered 14th of November 2024).

Background: Lung cancer is the leading cause of cancer-related mortality worldwide. Low-dose CT (LDCT) lung cancer screening (LCS) reduces lung cancer-specific mortality by 20%, yet participation remains low, often below 15%, compared with 60-75% for other cancer screening programmes. Barriers such as limited accessibility, stigma, fear of diagnosis, and misconceptions contribute to poor uptake, particularly among high-risk groups, including heavy smokers, ethnic minorities, and individuals from lower socioeconomic backgrounds. Various recruitment strategies-such as personalised invitations, media campaigns, and primary care referrals-have been implemented, but their effectiveness across different populations remains unclear. This umbrella review will synthesise evidence from systematic reviews to identify the most effective recruitment strategies for improving LCS participation.

Methods: This umbrella review will follow Joanna Briggs Institute guidelines and the PRIOR reporting framework. A systematic search of PubMed, Embase, Scopus, Web of Science, Cochrane Library, and systematic review registries will identify systematic reviews published before 31 October 2024. Eligible reviews must evaluate LCS recruitment strategies and report on at least one of the following: population reach, screening up take, adherence, patient experience, or implementation barriers. Quality will be assessed using AMSTAR 2, and overlapping primary studies will be mapped to prevent duplication. A narrative synthesis will categorise recruitment strategies, and a qualitative effectiveness ranking will summarise key findings.

Implications: Findings will inform LCS recruitment strategies in Europe, contributing to the EU4Health-funded EUCanScreen programme. This review will support efforts to improve uptake, reduce disparities, and enhance early detection and survival outcomes of lung cancer.

Background: Evidence-informed policymaking promotes the use of the best available evidence in a systematic and transparent manner to guide policy decisions. It aims to ensure that policies are grounded in credible and relevant evidence while also considering factors such as feasibility, sustainability, equity, and stakeholder input. The Global Evidence Commission has emphasised the necessity for stronger national evidence infrastructures and recommended that governments evaluate their evidence-support systems, focusing on the demand for evidence from policymakers, the supply of timely and relevant evidence, and the coordination between the two. To assist countries in reviewing their evidence-support systems, the Global Commission on Evidence to Address Societal Challenges developed the Rapid Evidence Support System Assessment (RESSA). Here, we outline the protocol for a RESSA of health policymaking being conducted in Ireland.

Methods: This study will adopt a flexible, mixed-methods design with four key stages: (1) a high-level website review, (2) an in-depth document review, (3) semi-structured interviews with key stakeholders, and (4) seeking feedback. For the document review, the data analysis and synthesis process will follow the READ approach, allowing for a systematic way to organise, interpret, and synthesise the information extracted from the selected documents. Interview data will be analysed using a thematic approach. Findings from both sources will be triangulated to ensure robust conclusions about the strengths and challenges of the evidence-support system for health policymaking.

Conclusions: This protocol outlines the methods for assessing Ireland's evidence support system for health policymaking. By documenting our approach in detail, we aim to enhance transparency and replicability, providing a foundation for easier comparison and contrast with similar assessments conducted by other groups. While this study focuses on health, the methodology and findings may also inform evidence-support systems in other sectors, such as climate and education.

Background: The third WHO Global patient safety challenge, "Medication Without Harm" aims to reduce severe avoidable medication related ham by 50% globally. One approach to reducing medication related harm is to develop interventions that improve prescribing. Audit and feedback is one such intervention that has been shown to have an effect on professional behaviour. With advancements in the data infrastructure of primary care it is now possible to harness routine prescribing data for ongoing and up-to-date comparative benchmarking. The aim of this study was to assess the usability and usefulness of a prescribing safety dashboard developed in Irish general practice.

Methods: Practices utilising the data analytics platform, MedVault opted in to share anonymous prescription data to enable the development of the prescribing safety dashboard. Participants from these practices who had previously expressed an interest in taking part in this qualitative study will be formally invited to take part. Recruited prescribers will take part in an online interview with a think aloud process where they will share their screen as they navigate the dashboard and verbalise their thoughts. This will be followed by a semi-structured interview where their views on prescribing safety and receiving feedback on prescribing will be explored. For the think aloud process, screen recordings will be reviewed alongside the transcripts, and analysed using Nielsen's five quality components of usability: learnability, efficiency, memorability, error recovery and satisfaction as a framework. An inductive thematic approach will be used to analyse GPs' perspectives on prescribing safety and feedback.

Discussion: This study will explore the usability and acceptability of a prescribing quality and safety dashboard. To design future interventions, policies, and quality improvement initiatives that make use of routine data, it is essential to understand how GPs engage with and use these tools. This understanding can help ensure such initiatives are developed in ways that maximise relevance, usability, and engagement.