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The State of the Art of Telemedicine Implementation Architecture: Rapid Umbrella Review of Systematic Reviews.
Background: The global push to scale up telemedicine services is challenged by complex, multilevel, multifaceted implementation and a lack of consensus on what the evidence-based essential building blocks of implementation are. Objective: We aimed to evaluate the evidence base supporting telemedicine implementation knowledge tools; identify shared conceptual constructs and outliers; and formulate recommendations to guide the design, development, and optimization of telemedicine services. Methods: We conducted implementation research using a rapid umbrella review, that is, an overview of systematic reviews, in accordance with PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses). In total, we searched 3 databases (PubMed, Web of Science, and Scopus) for studies focusing on telemedicine implementation frameworks, models, and tools, collectively referred to as "knowledge tools." Reviews meeting the operational definition of a systematically undertaken, secondary evidence synthesis, such as systematic and scoping reviews, and those published from January 2018 to May 2024 were considered. A meta-aggregative qualitative analysis was undertaken, comprising inductive thematic synthesis. Results: In total, 18 reviews were selected, encompassing 973 primary studies. Global perspectives were reflected in 61% (n=11) of the reviews, while 33% (n=6) focused on low- and middle-income country contexts. The primary research included in the reviews represented 63 countries, spanning the Americas, Europe, Africa, the Middle East, and Asia and the Pacific. Findings indicated substantial heterogeneity across the identified telemedicine implementation theories, models, and frameworks. However, following evidence synthesis, considerable convergence was observed, highlighting a state-of-the-art understanding of the essential requirements for a national telemedicine implementation ecosystem. These were categorized into "process" and "thematic" dimensions. Process dimensions included readiness and needs assessment, road map and planning, managing change, implementing telemedicine services, and continuous improvement and measuring performance. Thematic dimensions covered human and sociocultural aspects; organization, operations, management, and leadership; communication and coordination; policy, legal, and financial considerations; clinical health condition and quality of care; and the wider context. Conclusions: The findings of this study inform a pressing translational research knowledge gap in telemedicine implementation, hindering the implementation of high-quality, sustainable, and scalable telemedicine systems. The study contributes to building global consensus on the state of the art of key constructs in telemedicine implementation and recommends that future research focus on field-testing the evidence-based implementation tools to evaluate their usability and adaptability across diverse telemedicine contexts.
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Applications of artificial intelligence and the challenges in health technology assessment: a scoping review and framework with a focus on economic dimensions.
Background: Health Technology Assessment (HTA) is a crucial tool for evaluating the worth and roles of health technologies, and providing evidence-based guidance for their adoption and use. Artificial intelligence (AI) can enhance HTA processes by improving data collection, analysis, and decision-making. This study aims to explore the opportunities and challenges of utilizing artificial intelligence (AI) in health technology assessment (HTA), with a specific focus on economic dimensions. By leveraging AI's capabilities, this research examines how innovative tools and methods can optimize economic evaluation frameworks and enhance decision-making processes within the HTA context. Methods: This study adopted Arksey and O'Malley's scoping review framework and conducted a systematic search in PubMed, Scopus, and Web of Science databases. It examined the benefits and challenges of AI integration into HTA, with a focus on economic dimensions. Findings: AI significantly enhances HTA outcomes by driving methodological advancements, improving utility, and fostering healthcare innovation. It enables comprehensive assessments through robust data systems and databases. However, ethical considerations such as biases, transparency, and accountability emphasize the need for deliberate planning and policymaking to ensure responsible integration within the HTA framework. Conclusion: AI applications in HTA have significant potential to enhance health outcomes and decision-making processes. However, the development of robust data management strategies and regulatory frameworks is essential to ensure effective and ethical implementation. Future research should prioritize the establishment of comprehensive frameworks for AI integration, fostering collaboration among stakeholders, and improving data quality and accessibility on an ongoing basis.
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AI and omics technologies in biobanking: Applications and challenges for public health.
Objectives: Considering the growing inter of biobanks, artificial intelligence (AI) and omics research, and their critical impact on public health, this study aimed to explore the current and future public health implications and challenges of AI and omics-driven innovations in biobanking. Study design: Narrative literature review. Methods: A structured literature search was conducted in Scopus, PubMed, Web of Science and IEEExplore databases using relevant search terms. Additional references were identified through backward and forward citation chaining. Key themes were aggregated and analysed through thematic analysis. Results: Thirty-seven studies were selected for analysis, leading to the identification and categorisation of key developments. Several key technical, ethical and implementation challenges were also identified, including AI model selection, data accessibility, variability and quality issues, lack of robust and standardised validation methods, explainability, accountability, lack of transparency, algorithmic bias, privacy, security and fairness issues, and governance model selection. Based on these results, potential future scenarios of AI and omics integration in biobanking and their related public health implications were considered. Conclusions: While AI and omics-driven innovations in biobanking offer specific transformative public health benefits, addressing their technical, ethical and implementation challenges is crucial. Robust regulatory frameworks, feasible governance models, access to quality data, interdisciplinary collaboration, and transparent and validated AI systems are essential to maximise benefits and mitigate risks. Further research and policy development are needed to support the responsible integration of these technologies in biobanking and public health.
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Economic Evaluations in Electrophysiology in the Last 15 Years: A Systematic Review of the Literature.
Background: Electrophysiology (EP) procedures, including cardiac implantable electronic devices (CIEDs) and ablations, are widely used to manage arrhythmias and heart failure. These interventions, though effective, require substantial resources, prompting the need for systematic economic evaluations to inform healthcare decision-making. Methods: A systematic review of studies from 2007 to 2024 was conducted in two phases. Phase one assessed trends in economic evaluations of EP procedures, analyzing 129 studies across regions and timeframes. Phase two focused on cost-effectiveness analyses of implantable cardioverter defibrillators (ICDs), cardiac resynchronization therapy defibrillators (CRT-Ds), and atrial fibrillation (AF) ablation, examining outcomes like quality-adjusted life years (QALYs) and incremental cost-effectiveness ratios (ICERs), while identifying factors influencing economic results. Results: EP procedures generally demonstrated favorable cost-effectiveness, particularly in high-income regions. Studies on ICDs and CRT-Ds consistently supported their economic value for patients with arrhythmias or heart failure, while AF ablation showed potential for long-term benefits, particularly when compared to medical therapies. However, results varied by region, reflecting differences in healthcare systems, costs, and patient populations. Conclusions: The review highlights the overall cost-effectiveness of EP procedures in many settings but underscores the need for tailored economic evaluations in low- and middle-income countries. Simplified methodologies and greater attention to regional contexts are recommended to guide resource allocation and policy development globally.
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Exploring methods to assess environmental health inequalities in health impact assessments of local interventions: a systematic review within the JA PreventNCD project.
Background: Health Impact Assessment (HIA) procedures can include the assessment of inequalities and inequities associated with the distribution of environmental health risks and benefits, aimed at attenuating the exacerbation of environmental health disparities. This systematic review, conducted as part of the Joint Action Prevent Non-Communicable Diseases initiative, explores methods for assessing health inequalities and equity within HIA frameworks, particularly in local projects affecting the distribution of environmental risks and benefits. Methods: Adhering to the PRISMA guidelines, a systematic review of the scientific literature was conducted using the MEDLINE/PubMed, Scopus, and Embase databases, searching until March 8, 2024. Furthermore, a grey literature analysis encompassed the Institutional Repository for Information Sharing (IRIS) of the World Health Organization, to identify guidelines and recommendations addressing equity considerations in HIAs. Studies were included based on predefined eligibility criteria if they explored issues related to inequalities, inequities, and vulnerabilities within the context of HIAs. Data extraction focused on methodologies that incorporated equity considerations within the HIA framework, particularly concerning local urban planning initiatives, transport infrastructure, and industrial settings. Results: A total of 33 studies met the inclusion criteria. Among these, eight documents from the grey literature, identified as guidelines and guidance, underscored the importance of prioritizing equity to ensure that health impacts are addressed fairly across diverse population groups. The remaining 25 peer-reviewed studies employed a combination of quantitative and qualitative methodologies. Quantitative approaches, including exposure-response modeling and Geographic Information System (GIS) mapping, were utilized to evaluate spatial and demographic health disparities. Qualitative methods, such as focus groups, interviews, and participatory tools, provided insights into the lived experiences of vulnerable populations affected by local interventions. Studies addressing urban and transportation planning predominantly emphasized socioeconomic stratification, whereas those focused on industrial settings highlighted occupational hazards and community vulnerabilities. Conclusion: This review highlights the diverse and fragmented approaches used to address health inequalities and equity in HIA. It underscores the need for interdisciplinary and systematic methodologies that integrate quantitative and qualitative perspectives, ensuring equity remains a central consideration in policymaking and project implementation. Finally, it proposes a practical framework for integrating equity into HIA.
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Effects of interventions on physical activity behavior change in children and adolescents based on a trans-theoretical model: a systematic review.
Background: The Trans-theoretical Model (TTM) has been applied in numerous empirical studies concerning physical activity (PA) interventions for children and adolescents. Consequently, the aim of this review is to identify and synthesize the evidence regarding the effectiveness of TTM-based interventions in promoting PA behavior change among this demographic, with the goal of informing future research and policy development. Methods: A systematic review was performed followed the PRISMA guideline, protocol was registered in PROSPERO (CRD42023416216). Computer-based searches were conducted in the CNKI, Wan-Fang, VIP, Web of Science (WOS), PubMed, and EBSCO databases to identify relevant literature. Two researchers independently conducted the literature screening and quality assessment. The quality of the randomized controlled trials (RCTs) was evaluated using the Risk of Bias Assessment Tool version 5.1.0, as recommended by the Cochrane Collaboration Network. For quality assessment of quasi experiments (QEs), the Risk Of Bias In Non-randomised Studies-of Interventions (ROBINS-I) tool was employed. Results: A total of 22 articles were included in the systematic review. Stage-matched interventions and interventions designed based on a more complete structure of the TTM are more likely to promote an increase in the actual levels of PA among children and adolescents, as well as to facilitate an increase in their PA stages. Interventions that combine health information and health behavior feedback are more likely to promote an increase in actual PA levels and the advancement of PA stages; while interventions that include PA programs are more likely to facilitate improvements in health indicators. Conclusion: The effectiveness of TTM-based PA behavior change interventions for children and adolescents depends on the specific measures employed. Interventions that are stage-matched and integrate multiple behavior change techniques using the complete TTM structure are more likely to enhance PA and its associated health benefits. However, there are several normative issues that remain. These include the misuse of incremental stages as a substitute for PA, neglect of stage specificity when applying the model, a lack of framework for behavior change techniques in targeted interventions, and an absence of a dynamic feedback process.
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信息框架效应理论在健康管理领域应用的范围综述
目的 对信息框架效应理论在健康管理领域内的应用进行范围综述,为相关研究者利用信息框架效应理论进行实践研究提供参考。方法 采用Arksey和O’ Malley范围综述的方法,系统检索中国知网、万方、维普、Sinomed、PubMed、Web of Science、Cochrane Library、Embase、CINAHL等国内外数据库,检索时间为建库至2023年12月,收集信息框架效应理论应用于健康管理领域的相关研究。结果 共检索出2 855篇文献,最终共纳入16篇文献。其中英文15篇,中文1篇。基于信息框架效应的健康管理内容要素涉及提供疾病知识、治疗等健康相关信息,自我护理,决策支持3个方面;应用形式涵盖视频、文本信息、电子信息、知识讲座、随访、健康手册、手机短信7种形式;结局指标涉及自我管理行为、身体活动行为、药物和治疗依从性3个方面,健康管理均有积极效果。结论 基于信息框架效应理论的实践研究是可行有效的,能显著提高患者的健康行为和健康信念,应用前景广阔;但我国研究与国外研究尚存在较大差距,我国学者应重视对该理论的解读,并在其指导下启动在健康管理方面的实践研究。
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Systematic literature review of cost-effectiveness analyses of adult 15- and 20-valent pneumococcal vaccines.
Background: The economic and public health benefits of adult pneumococcal vaccines vary across countries due to different epidemiology and costs. We systematically reviewed and summarized findings and assumptions of cost-effectiveness analyses (CEA) of the recently introduced 15- and 20-valent pneumococcal conjugate vaccines (PCV15 and PCV20) in adults. Methods: We performed a systematic search for CEA studies of PCV15 and/or PCV20 versus existing strategies via PubMed, EMBASE, CEA Registry, EconLit, HTA Database, and NITAG resource center through April 23, 2024. Study characteristics, methods, assumptions, and findings were extracted independently by two reviewers; quality was assessed using ECOBIAS. Results were synthesized qualitatively to summarize key attributes and conclusions. Results: Of 137 identified records, 26 studies were included; the majority (24/26) concerned high-income countries. All employed static Markov-type models comparing higher-valent PCVs used alone or in combination with 23-valent pneumococcal polysaccharide vaccine (PPSV23) to current recommendations (PPSV23 alone, PCV13 alone, PCV13 + PPSV23, no vaccination). Most studies (22/26) concluded PCV20 used alone was cost-saving (dominant) or cost-effective compared to other adult pneumococcal strategies (PPSV23 alone, PCV13 ± PPSV23, PCV15 ± PPSV23, or no vaccination). PCVs were generally assumed to have serotype-specific effectiveness equal to PCV13 efficacy in the pivotal trial, though four studies used estimates from a Delphi panel; protection was assumed to last between 10 and 20 years. PPSV23 was assumed to have lower effectiveness against non-bacteremic pneumonia and shorter duration of protection. Herd effects from higher-valent PCVs in childhood (12/26), serotype replacement (2/26), or both (1/26) were included in half (13/26) of studies, which attenuated adult vaccine impact. Most studies were assessed as low risk of bias; five abstracts did not provide sufficient information for assessment. Conclusion: Current evidence indicates that 20-valent PCV used alone is likely to be cost-effective or dominate other adult pneumococcal strategies. Future research is needed to address remaining uncertainties in assumptions and to support evidence-based policymaking.
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基于COSMIN的高血压健康促进行为评估工具的系统评价
目的 采用健康测量工具选择的共识标准(COSMIN)对高血压健康促进行为的评估工具进行系统评价。方法 计算机检索Embase、Web of Science、PubMed、Cochrane Library、中国生物医学文献服务系统、中国知网、万方数据知识服务平台中关于高血压健康促进行为评估工具的开发、信效度检验的文献,检索时限为建库至2024-05-25。由两名研究生独立进行文献筛选与资料提取。采用COSMIN偏倚风险评价清单评价纳入评估工具的方法学质量,根据COSMIN质量准则评价纳入评估工具的测量学属性质量。应用改良版定量系统评价证据分级(GRADE)方法评价证据等级,根据测量学属性质量评价结果及证据等级确定评估工具的推荐级别。结果 最终纳入文献14篇,共涉及14个高血压健康促进行为评估工具,其中运动行为改变评定量表(MCPAQ)、高血压患者限盐饮食行为改变评定量表(MCRSDH)、运动决策平衡修订量表(DBS)、中文版高血压自我护理量表(HBPSCP)、高血压自我护理量表(HTN-SCP)、健康促进生活方式量表-Ⅱ(HPLP-Ⅱ)中文版为高血压健康促进行为评估工具在不同国家的跨文化...
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Residents' willingness and awareness to participate in internet+nursing service in China: A meta-analysis.
Background: The internet + nursing service is an important initiative for implementing the strategy of healthy China and actively responding to the aging of the population. However, the current literature on residents' awareness and willingness to participate is insufficient and presents large variations and limitations. Therefore, this study aims to systematically evaluate the awareness and willingness of Chinese residents to participate in internet + nursing service to comprehensively understand the level of awareness and acceptance of this emerging service model among Chinese residents and to provide strong support for relevant policy formulation and service optimization. Methods: The PubMed, Embase, Cochrane Library, Web of Science, CNKI, WanFang Data, SinoMed, and VIP databases were electronically searched to collect cross-sectional studies related to the awareness and willingness of Chinese residents to participate in internet + nursing service from inception to January 2024. Two reviewers independently screened the literature, extracted the data, and assessed the risk of bias of the included studies. Results: A total of 27 cross-sectional studies involving 11,761 subjects were included. The results of the meta-analysis showed that the percentage of Chinese residents willing to participate in internet + nursing service was 76.3% (95% CI [71.2%, 81.3%]). The results of the subgroup analysis showed that residents who lived in Western regions (82.1%), had employee medical insurance (85.9%), were suffering from other diseases (89.2%), were under the age of 60 (87.8%), were not married (78.9%), and had an undergraduate degree or above (85.5%) had a relatively high willingness to participate in internet + nursing service. The rate of awareness of internet + nursing service among Chinese residents was 48.6% (95% CI [24.1%, 73.2%]), which shows a downwards trend over time (67.4% in 2019, 56.1% in 2020, and 45.1% in 2021). Conclusion: The willingness to participate in internet + nursing service among Chinese residents is high, but the awareness rate is low. It is necessary to improve the awareness and willingness of Chinese residents to use internet + nursing service through various channels and aspects of publicity and promotion to achieve the goal of innovating the health service model, accurately connecting with the diverse health needs of people, and actively responding to the aging population.
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Healthcare delivery in the arctic-telehealth prospects.
The Arctic region, characterised by its remote and geographically challenging environment, is home to predominantly Indigenous populations who experience significant healthcare disparities compared to urban counterparts. This paper synthesises evidence on the persistent challenges in delivering healthcare in the Arctic, including geographical remoteness, healthcare personnel shortages, and cultural and language barriers. Telehealth emerges as a crucial solution, offering a nuanced approach to overcoming physical and systemic barriers. We review current implementations of telehealth in the Arctic, highlighting successful adaptations to local cultural contexts and technological limitations. By integrating a patient-centred approach, infrastructure readiness, and relevant telehealth services, a holistic healthcare delivery model tailored for the Arctic environment is proposed. New type of technologies is also proposed to enhance remote care possibilities. This paper underscores the need for collaborative efforts in research, policy making, and healthcare provision to ensure the sustainability and effectiveness of health services in the Arctic, aiming to close the gap in health equity. Key references from seminal works and recent studies provide a foundation for the discussions and recommendations presented.
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Understanding the use of telemedicine across different opioid use disorder treatment models: A scoping review
INTRODUCTION: The COVID-19 pandemic has instigated the development of telemedicine-mediated provision of medications for opioid use disorder such as buprenorphine and methadone, referred to as TMOUD in this study. As services start to return to pre-pandemic norms, there is a debate around the role of TMOUD as addition to or replacement of the conventional cascade of care for people with opioid use disorder (PWOUD). This scoping review is designed to characterize existing TMOUD services and provide insights to enable a more nuanced discussion on the role of telemedicine in the care of PWOUD. METHODS: The literature search was conducted in OVID Medline, CINAHL, and PsycINFO, from inception up to and including April 2023, using the Joanna Briggs Institute methodology for scoping reviews. The review considered any study design that detailed sufficient descriptive information on a given TMOUD service. A data extraction form was developed to collect and categorize a range of descriptive characteristics of each discrete TMOUD model identified from the obtained articles. RESULTS: A total of 45 articles met the inclusion criteria, and from this, 40 discrete TMOUD services were identified. In total, 33 services were US-based, three from Canada, and one each from India, Ireland, the UK, and Norway. Through a detailed analysis of TMOUD service characteristics, four models of care were identified. These were TMOUD to facilitate inclusion health, to facilitate transitions in care, to meet complex healthcare needs, and to maintain opioid use disorder (OUD) service resilience. CONCLUSIONS: Characterizing TMOUD according to its functional benefits to PWOUD and OUD services will help support evidence-based policy and practice. Additionally, particular attention is given to how digital exclusion of PWOUD can be mitigated against.
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国内外居民数字健康素养影响因素的meta分析
目的:系统探讨国内外居民数字健康素养的影响因素,为进一步提升居民数字健康素养提供参考依据。方法:选取符合标准的数字健康素养相关中英文文献进行meta分析,探究居民数字健康素养影响因素及其影响程度,进一步分析国内外研究情境和健康状况在其他影响因素与居民数字健康素养间的调节效应。结果:共检索到3278篇文献,其中32篇纳入本研究;年龄、文化程度、社会支持等17个因素与居民数字健康素养相关(r>0.1);国内外研究情境在年龄和文化程度与数字健康素养间有显著的调节作用(P<0.05);健康状况在计算机素养和家庭结构与数字健康素养间有显著调节作用(P<0.05)。结论:居民数字健康素养受计算机素养、文化程度、健康信息搜索频率等因素影响,国内外研究情境和健康状况在居民数字健康素养及其影响因素间起调节作用。未来应针对不同社会人口学特征和健康需求的人群进行精准干预,提高居民数字健康素养,转变居民健康意识,进一步实现全民健康。
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维持性血液透析病人人工血管内瘘自我管理的最佳证据总结
目的:总结维持性血液透析病人人工血管内瘘(AVG)自我管理的相关证据。方法:系统检索国内外相关指南库、肾内科相关专业网站及国内外相关医学数据库中有关维持性血液透析病人AVG相关文献,文献类型包括指南、专家共识、临床决策、证据总结、系统评价等,检索时限从建库至2023年11月30日。由循证团队进行文献纳入、质量评价、证据提取及推荐强度进行汇总。结果:本研究共纳入文献15篇,其中指南8篇,专家共识1篇,临床决策3篇,系统评价2篇,证据总结1篇。从健康教育、AVG的监测与体格检查、日常维护、并发症识别和质量持续改进5个方面形成27条推荐意见。结论:总结维持性血液透析病人AVG自我管理相关证据,可为临床病人对AVG自我管理提供参考,从而提高AVG远期通畅率。
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The role of economic evaluation in modelling public health and social measures for pandemic policy: a systematic review.
Background: Dynamic transmission models are often used to provide epidemiological guidance for pandemic policy decisions. However, how economic evaluation is typically incorporated into this technique to generate cost-effectiveness estimates of pandemic policy responses has not previously been reviewed. Methods: We systematically searched the Embase, PubMed and Scopus databases for dynamic epidemiological modelling studies that incorporated economic evaluation of public health and social measures (PHSMs), with no date restrictions, on 7 July 2024. Results: Of the 2,719 screened studies, 51 met the inclusion criteria. Most studies (n = 42, 82%) modelled SARS-CoV-2. A range of PHSMs were examined, including school closures, testing/screening, social distancing and mask use. Half of the studies utilised an extension of a Susceptible-Exposed-Infectious-Recovered (SEIR) compartmental model. The most common type of economic evaluation was cost-effectiveness analysis (n = 24, 47%), followed by cost-utility analysis (n = 17, 33%) and cost-benefit analysis (n = 17, 33%). Conclusions: Economic evaluation is infrequently incorporated into dynamic epidemiological modelling studies of PHSMs. The scope of this research should be expanded, given the substantial cost implications of pandemic PHSM policy responses.
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消化道肿瘤患者居家肠内营养管理的最佳证据总结
目的 为进一步规范消化道肿瘤患者家庭肠内营养支持治疗流程和居家管理,检索并总结相关证据。方法 系统检索PubMed、Web of Science、Cochrane Library、国际指南协作网、美国国家综合癌症网、医脉通、中国知网、万方数据库、中国生物医学文献数据库等数据库和网站中,关于不同肠内营养管理方法在居家消化道肿瘤患者中应用的相关证据。由两名研究者分别进行文献质量评价和证据提取,总结居家消化道肿瘤患者肠内营养管理的最佳证据。结果 共纳入13篇文献,其中4篇指南、1篇专家共识、5篇系统评价、3篇随机对照研究,从筛查与评估、适应证与禁忌证、家庭肠内营养方式、监测与终止、健康教育和效果评价6个方面进行汇总,共总结出24条最佳证据。结论 本研究总结了居家消化道肿瘤患者肠内营养管理的最佳证据,提示临床应组建多学科团队,从营养评估、营养支持方式选择、健康教育等多方面入手,为消化道肿瘤患者提供规范和全面的居家肠内营养管理措施,以改善肿瘤患者的居家营养状况,提高其生活质量。
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大语言模型在护理学领域应用的范围综述
目的 对大语言模型在护理学领域的应用研究进行范围综述,为相关研究提供参考。方法 遵循范围综述方法,系统检索中英文数据库中相关大语言模型在护理学领域应用的相关研究。检索时限为建库至2024年5月,由2名研究人员独立筛选提取资料,并对纳入文献进行总结和分析。结果 共纳入33篇文献,大语言模型在护理学领域的应用主要集中于护理教育(48.49%)、临床护理(42.42%),护理科研(3.03%)及综合应用(6.06%);其应用形式主要包括护理专业考试或护理基础知识测试、护理教学写作、临床模拟场景构建、制订护理计划、协助患者病情管理、为患者提供专业知识和信息支持等。大语言模型已经在护理教育和临床护理的患者管理方面展现出了显著的应用效果,但在知识应用、回答临床问题、进行专业判断或决策时仍有缺陷,不足以取代人工。结论 大语言模型在我国护理学领域的研究处于起步阶段,未来的研究应当积极整合前沿技术,以促进其在该领域的深入应用,同时,应加快制定和推行标准化的使用准则和指南,确保技术应用的安全性和有效性,切实推动护理学领域的创新与发展。
研究证据
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Data Analytics to Support Policy Making for Noncommunicable Diseases: Scoping Review.
Background: There is an emerging need for evidence-based approaches harnessing large amounts of health care data and novel technologies (such as artificial intelligence) to optimize public health policy making. Objective: The aim of this review was to explore the data analytics tools designed specifically for policy making in noncommunicable diseases (NCDs) and their implementation. Methods: A scoping review was conducted after searching the PubMed and IEEE databases for articles published in the last 10 years. Results: Nine articles that presented 7 data analytics tools designed to inform policy making for NCDs were reviewed. The tools incorporated descriptive and predictive analytics. Some tools were designed to include recommendations for decision support, but no pilot studies applying prescriptive analytics have been published. The tools were piloted with various conditions, with cancer being the least studied condition. Implementation of the tools included use cases, pilots, or evaluation workshops that involved policy makers. However, our findings demonstrate very limited real-world use of analytics by policy makers, which is in line with previous studies. Conclusions: Despite the availability of tools designed for different purposes and conditions, data analytics is not widely used to support policy making for NCDs. However, the review demonstrates the value and potential use of data analytics to support policy making. Based on the findings, we make suggestions for researchers developing digital tools to support public health policy making. The findings will also serve as input for the European Union-funded research project ONCODIR developing a policy analytics dashboard for the prevention of colorectal cancer as part of an integrated platform.
研究证据
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Community-Based Health Information Systems in Africa: A Scoping Review of Data Generation, Utilization, and Community Empowerment.
Introduction: The community-based health information system (CBHIS) is a vital component of the community health system, as it assesses community-level healthcare service delivery and generates data for community health programme planning, monitoring, and evaluation. CBHIS promotes data-driven decision-making, by identifying priority interventions and programs, guiding resource allocation, and contributing to evidence-based policy development. Objective: This scoping review aims to comprehensively examine the use of CBHIS in African countries, focusing on data generation, pathways, utilisation of CBHIS data, community accessibility to the data and use of the data to empower communities. Methods: We utilised Arksey and O'Malley's scoping review methodology. We searched eight databases: PubMed, EMBASE, HINARI, Cochrane Library, Web of Science, Scopus, Google Scholar, and grey literature databases (Open Grey and OAIster). We synthesised findings using a thematic approach. Results: Our review included 55 articles from 27 African countries, primarily in Eastern and Southern Africa, followed by West Africa. Most of the studies were either quantitative (42%) or qualitative (33%). Paper-based systems are primarily used for data collection in most countries, but some have adopted electronic/mobile-based systems or both. The data flow for CBHIS varies by country and the tools used for data collection. CBHIS data informs policies, resource allocation, staffing, community health dialogues, and commodity supplies for community health programmes. Community dialogue is the most common approach for community engagement, empowerment, and sharing of CBHIS data with communities. Community empowerment tends towards health promotion activities and health provider-led approaches. Conclusion: CBHIS utilises both paper-based and electronic-based systems to collect and process data. Nevertheless, most countries rely on paper-based systems. Most of the CBHIS investments have focused on digitisation and enhancing data collection, process, and quality. However, there is a need to shift the emphasis towards enabling data utilisation at the community level and community empowerment.
研究证据
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