Vital Decisions

Presents findings from surveys conducted in 2001 and 2002. Looks at how Internet users make decisions about what online health information to trust. Includes a guide from the Medical Library Association about smart health-search strategies

Internet as a source of medicines information (MI) among frequent internet users

Background: The internet is widely and increasingly used to search for health information. Previous studies have focused mainly on health information on the internet and not specifically on medicines information (MI). Objectives: The aim of this study was to explore the internet as a source of MI compared to other sources of MI; to identify those who use the internet as a source of MI; and to describe patterns of use of the internet as a source of MI. Methods: A cross-sectional design employed a web-based questionnaire posted by patients' and other organizations as well as pharmacies on their websites during six weeks in the beginning of 2014. Logistic regression analysis was used to assess associations of background variables to the use of different MI sources. Results: The most frequently used MI sources among respondents (n = 2489) were package leaflets (90%), pharmacists (83%), physicians (72%), and the internet (68%). According to a multivariate analysis, internet use for MI was associated with female gender, age <65 years, higher education, daily use of the internet, and continuous use of vitamins or herbals. MI was most commonly searched from a Finnish health portal (56%) and websites of pharmacies (41%). Of the respondents, nearly half (43%) used search engines to find information from the internet. The names of the medicinal product, symptom or disease were the most commonly used search terms. Conclusions: Well-educated, young women tend to search MI on the internet. Health care professionals should discuss reliable MI websites and tools that can help patients evaluate the reliability of information.Peer reviewe

Doctor of Philosophy

dissertationThe use of the various complementary and alternative medicine (CAM) modalities for the management of chronic illnesses is widespread, and still on the rise. Unfortunately, tools to support consumers in seeking information on the efficacy of these treatments are sparse and incomplete. The goals of this work were to understand CAM information needs in acquiring CAM information, assess currently available information resources, and investigate informatics methods to provide a foundation for the development of CAM information resources. This dissertation consists of four studies. The first was a quantitative study that aimed to assess the feasibility of delivering CAM-drug interaction information through a web-based application. This study resulted in an 85% participation rate and 33% of those patients reported the use of CAMs that had potential interactions with their conventional treatments. The next study aimed to assess online CAM information resources that provide information on drug-herb interactions to consumers. None of the sites scored high on the combination of completeness and accuracy and all sites were beyond the recommended reading level per the US Department of Health and Human Services. The third study investigated information-seeking behaviors for CAM information using an existing cohort of cancer survivors. The study showed that patients in the cohort continued to use CAM well into survivorship. Patients felt very much on their own in dealing with issues outside of direct treatment, which often resulted in a search for options and CAM use. Finally, a study was conducted to investigate two methods to semi-automatically extract CAM treatment relations from the biomedical literature. The methods rely on a database (SemMedDB) of semantic relations extracted from PubMed abstracts. This study demonstrated that SemMedDB can be used to reduce manual efforts, but review of the extracted sentences is still necessary due to a low mean precision of 23.7% and 26.4%. In summary, this dissertation provided greater insight into consumer information needs for CAM. Our findings provide an opportunity to leverage existing resources to improve the information-seeking experience for consumers through high-quality online tools, potentially moving them beyond the reliance on anecdotal evidence in the decision-making process for CAM

eHealth interventions for people with chronic kidney disease

This is a protocol for a Cochrane Review (Intervention). The objectives are as follows: This review aims to look at the benefits and harms of using eHealth interventions in the CKD population

Targeted, structured text messaging to improve dietary and lifestyle behaviours for people on maintenance haemodialysis (KIDNEYTEXT): Study protocol for a randomised controlled trial

Introduction Managing nutrition is critical for reducing morbidity and mortality in patients on haemodialysis but adherence to the complex dietary restrictions remains problematic. Innovative interventions to enhance the delivery of nutritional care are needed. The aim of this phase II trial is to evaluate the feasibility and effectiveness of a targeted mobile phone text messaging system to improve dietary and lifestyle behaviours in patients on long-term haemodialysis. Methods and analysis Single-blinded randomised controlled trial with 6 months of follow-up in 130 patients on haemodialysis who will be randomised to either standard care or KIDNEYTEXT. The KIDNEYTEXT intervention group will receive three text messages per week for 6 months. The text messages provide customised dietary information and advice based on renal dietary guidelines and general healthy eating dietary guidelines, and motivation and support to improve behaviours. The primary outcome is feasibility including recruitment rate, drop-out rate, adherence to renal dietary recommendations, participant satisfaction and a process evaluation using semistructured interviews with a subset of purposively sampled participants. Secondary and exploratory outcomes include a range of clinical and behavioural outcomes and a healthcare utilisation cost analysis will be undertaken. Ethics and dissemination The study has been approved by the Western Sydney Local Health District Human Research Ethics Committee-Westmead. Results will be presented at scientific meetings and published in peer-reviewed publications. Trial registration number ACTRN12617001084370; Pre-results

A matter of words: NLP for quality evaluation of Wikipedia medical articles

Automatic quality evaluation of Web information is a task with many fields of applications and of great relevance, especially in critical domains like the medical one. We move from the intuition that the quality of content of medical Web documents is affected by features related with the specific domain. First, the usage of a specific vocabulary (Domain Informativeness); then, the adoption of specific codes (like those used in the infoboxes of Wikipedia articles) and the type of document (e.g., historical and technical ones). In this paper, we propose to leverage specific domain features to improve the results of the evaluation of Wikipedia medical articles. In particular, we evaluate the articles adopting an "actionable" model, whose features are related to the content of the articles, so that the model can also directly suggest strategies for improving a given article quality. We rely on Natural Language Processing (NLP) and dictionaries-based techniques in order to extract the bio-medical concepts in a text. We prove the effectiveness of our approach by classifying the medical articles of the Wikipedia Medicine Portal, which have been previously manually labeled by the Wiki Project team. The results of our experiments confirm that, by considering domain-oriented features, it is possible to obtain sensible improvements with respect to existing solutions, mainly for those articles that other approaches have less correctly classified. Other than being interesting by their own, the results call for further research in the area of domain specific features suitable for Web data quality assessment

Examining adherence to activity monitoring devices to improve physical activity in adults with cardiovascular disease: A systematic review

Background Activity monitoring devices are currently being used to facilitate and monitor physical activity. No prior review has examined adherence to the use of activity monitoring devices amongst adults with cardiovascular disease. Methods Literature from June 2012 to October 2017 was evaluated to examine the extent of adherence to any activity monitoring device used to collect objective physical activity data. Randomized control trials comparing usual care against the use of an activity monitoring device, in a community intervention for adults from any cardiovascular diagnostic group, were included. A systematic search of databases and clinical trials registers was conducted using Joanna Briggs Institute methodology. Results Of 10 eligible studies, two studies reported pedometer use and eight accelerometer use. Six studies addressed the primary outcome. Mean adherence was 59.1% (range 39.6% to 85.7%) at last follow-up. Studies lacked equal representation by gender (28.6% female) and age (range 42 to 82 years). Conclusion This review indicates that current research on activity monitoring devices may be overstated due to the variability in adherence. Results showed that physical activity tracking in women and in young adults have been understudied

Public Health at the Public Library: Preventive Health Programs Implemented in Large Public Libraries

Amid the opioid epidemic and COVID-19 pandemic, the public sector is consumed with health promotion and disease prevention. Preventive programs serve a significant purpose in ensuring population health and reducing burden on the healthcare system (Cohen et al., 2008; Neumann & Cohen, 2009). People are increasingly turning to educational resources outside of the traditional healthcare sector to ward off diseases or alleviate pre-existing conditions (Eakin et al., 1980; Eng et al., 1998). Public library systems often carry such resources, in print and multimedia form, at no cost. Some libraries are providing health programming to supplement, contextualize, or incentivize the use of such resources (Murray, 2008; National Network of Libraries of Medicine, 2014). This study examines preventive health programming offered in the largest public library systems nationwide