Using a Question Answering System to Enhance Knowledge and Improve the Exchange of Information among Physicians

Due to limited time, physicians often find it challenging to find the exact answers to their questions among search engine results; however, question and answer (Q&A) systems can facilitate more rapidly identify accurate solutions. This study aims to develop and evaluate a Q&A system for physicians at Tabriz University of Medical Sciences. Four clinical and informatics experts and the two health information managers agreed on 19 features and themes throughout two focus group meetings. Subsequently, a system was developed on a MySQL database using the PHP web development language and then uploaded to the web. Finally, the system was opened up to 40 users and, over three months, evaluated using a community evaluation questionnaire and the six-dimension Users’ Experience Questionnaire. The focus group results in determining the features of the Q&A system consisted of 19 requirements. The average attractiveness, perspicuity, efficiency, dependability, stimulation, and novelty were equal to 1.76, 1.625, 1.9, 1.425, 1.475, and 1.375, respectively. The Q&A system improved the tasks such as share of knowledge, transfer of information, social partnership, and cooperation among users. The physicians were able to obtain the information they required through contact with their co-practitioners over the system.https://dorl.net/dor/20.1001.1.20088302.2021.19.2.14.

Clinical Risk Factors for Early-Onset Sepsis in Neonates: An International Delphi Study

Background: Despite growing evidence, there is still uncertainty about potentially modifiable risk factors for neonatal early-onset sepsis (EOS). This study aimed to identify potential clinical risk factors for EOS based on a literature review and expert opinions. Methods: A literature search was conducted in PubMed (MEDLINE), Cochrane, Embase, and Scopus databases. Articles in English, published up to May 2021, on clinical risk factors for neonatal EOS were included. Initially, a questionnaire on risk factors for EOS was developed and validated. The fuzzy Delphi method (FDM) was used to formulate the final version of the questionnaire. The validity of the risk factors was assessed using the Chi square test. P<0.05 was considered statistically significant. Results: In the review phase, 30 risk factors were approved by two neonatologists and included in the FDM phase. In total, 25 risk factors met the consensus criteria and entered the validation phase. During the observational study, 114 neonates (31 with and 83 without EOS) were evaluated for two months. The results of the Chi square test showed that cesarean section was not a significant risk factor for EOS (P=0.862). The need for mechanical ventilation and feed intolerance was observed in about 70% of neonates with EOS, and therefore considered significant risk factors for EOS (P<0.001). Finally, 26 potential clinical risk factors were determined. Conclusion: Neonatal-related risk factors for EOS were birth weight, one-min Apgar score, and prematurity. Maternal-related risk factors were gestational age and urinary tract infection. Delivery-related risk factors were premature rupture of membranes, chorioamnionitis, and intrapartum fever

National Minimum Data Set for Antimicrobial Resistance Management: Toward Global Surveillance System

Background: Success of infection treatment depends on the availability of accurate, reliable, and comprehensive data, information, and knowledge at the point of therapeutic decision-making. The identification of a national minimum data set will support the development and implementation of an effective surveillance system. The goal of this study was to develop a national antimicrobial resistance surveillance minimum data set. Methods: In this cross-sectional and descriptive study, data were collected from selected pioneering countries and organizations which have national or international antimicrobial resistance surveillance systems. A minimum data set checklist was extracted and validated. The ultimate data elements of the minimum data set were determined by applying the Delphi technique. Results: Through the Delphi technique, we obtained 80 data elements in 8 axes. The resistance data categories comprised basic, clinical, electronic reporting, infection control, microbiology, pharmacy, World Health Organization-derived, and expert-recommended data. Relevance coding was extracted based on the Iranian electronic health record coding system. Conclusion: This study provides a set of data elements and a schematic framework for the implementation of an antimicrobial resistance surveillance system. A uniform minimum data set was created based on key informants’ opinions to cover essential needs in the early implementation of a global antimicrobial resistance surveillance system in Iran

Designing an Electronic Medical Record System of Infants in Hospitals of Tabriz University of Medical Sciences

Introduction: Developing an accurate and comprehensive electronic database which can capture and store adequate, accurate and timely data related to infants is an essential step. The aim of this study was to design an electronic medical record system for infants hospitalized in neonatal intensive care unit at the Hospitals of Tabriz University of Medical Sciences. Method: This was an applied-developmental study. At first, current status of a data recording process in hospitals was studied. Then data elements were determined and the new system was modeled. The proposed architecture is based on three-tier architecture. Services such as reporting and user access control levels were implemented. Design of the user interface layer was performed by using Asp.net framework and HTML. This system is available in private network of Tabriz University of Medical Sciences for authorized users since 2014. Results: In data access layer, the minimum data elements determined at the seven categories of information. To design a data model, 65 entities were defined with their attributes and relationships. In business layer, the key processes of the system were designed as system use cases. This system provides the real time and online data storage and retrieval for users at the point of care. Conclusion: The design and implementation of electronic medical records is an effective step in managing infant’s health data. Using the appropriate architecture and standard templates lead to enhanced efficient performance, function, and storage and retrieval of health data

Applications of virtual and augmented reality in infectious disease epidemics with a focus on the COVID-19 outbreak

The pandemics of major infectious diseases often cause public health, economic, and social problems. Virtual reality (VR) and augmented reality (AR), as two novel technologies, have been used in many fields for emergency management of disasters. The objective of this paper was to review VR and AR applications in the emergency management of infectious outbreaks with an emphasis on the COVID-19 outbreak. A search was conducted in MEDLINE (PubMed), Embase, IEEE, Cochrane Library, Google Scholar, and related websites for papers published up to May 2, 2020. The VR technology has been used for preventing or responding to infections by simulating human behaviors, infection transmission, and pathogen structure as a means for improving skills management and safety protection. Telehealth, telecommunication, and drug discovery have been among the other applications of VR during this pandemic. Moreover, AR has also been used in various industries, including healthcare, marketing, universities, and schools. Providing high-resolution audio and video communication, facilitating remote collaboration, and allowing the visualization of invisible concepts are some of the advantages of using this technology. However, VR has been used more frequently than AR in the emergency management of previous infectious diseases with a greater focus on education and training. The potential applications of these technologies for COVID-19 can be categorized into four groups, i.e., 1) entertainment, 2) clinical context, 3) business and industry, and 4) education and training. The results of this study indicate that VR and AR have the potential to be used for emergency management of infectious diseases. Further research into employing these technologies will have a substantial impact on mitigating the destructive effects of infectious diseases. Making use of all the potential applications of these technologies should be considered for the emergency management of the current pandemic and mitigating its negative impacts

Comparison of coronary artery disease guidelines with extracted knowledge from data mining

Introduction: Coronary artery disease (CAD) is one of the major causes of disability and death in the world. Accordingly utilizing from a national and update guideline in heart-related disease are essential. Finding interesting rules from CAD data and comparison with guidelines was the objectives of this study. Methods: In this study 1993 valid and completed records related to patients (from 2009 to 2014) who had suffered from CAD were recruited and analyzed. Total of 25 variable including a target variable (CAD) and 24 inputs or predictor variables were used for knowledge discovery. To perform comparison between extracted knowledge and well trusted guidelines, Canadian Cardiovascular Society (CCS) guideline and US National Institute of Health (NIH) guideline were selected. Results of valid datamining rules were compared with guidelines and then were ranked based on their importance. Results: The most significant factor influencing CAD was chest pain. Elderly males (age >54) have a high probability to be diagnosed with CAD. Diagnostic methods that are listed in guidelines were confirmed and ranked based on analyzing of local CAD patients data. Knowledge discovery revealed that blood test has more diagnostic value among other medical tests that were recommended in guidelines. Conclusion: Guidelines confirm the achieved results from data mining (DM) techniques and help to rank important risk factors based on national and local information. Evaluation of extracted rules determined new patterns for CAD patients

Simple and Efficient Measurement of the User Experience in Health Information Systems: A Persian Version

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Effectiveness of virtual reality-based exercise therapy in rehabilitation: A scoping review

Background: When it comes to rehabilitation following many injuries and disabilities, exercise therapy is a long, arduous, and tedious process. Therefore, there is a need to employ new methods to increase the frequency, duration, and intensity of the exercises, and to boost motivation and satisfaction of the patients in a way that they can better perform the exercises. In this regard, virtual reality (VR) is an emerging technology that can be an effective tool in mitigating therapeutic challenges. Objectives: The main objective of the current study was to evaluate the effectiveness of VR-based exercise therapy to highlight areas for future studies in rehabilitation. Methods: The scoping review methodology was used to comprehensively search for and identify related papers in MEDLINE (PubMed), Cochrane Database of Systematic Reviews, EMBASE, IEEE, and Web of Science, while grey literature was also searched. Studies that used VR for exercise therapy were included in the current review. Quality assessment was performed using the Physiotherapy Evidence Database. The consensus was reached following two reviewers’ independent inclusion screening, data extraction, and appraisal. Results: Among 2887 identified studies, 26 papers were eligible to be included in this review. The results showed the positive effects of VR-based exercise therapy in a variety of conditions or disorders. With regard to treatment objectives, VR-based exercise therapy has been more commonly considered for the improvement of pain (41%), functional ability (31%), and muscular strength (24%). According to the findings, compared to other VR devices, Nintendo Wii and Kinect are 41% and 24% more common, respectively. Conclusions: This review provides evidence for the potential effectiveness of virtual reality-based exercise therapy for the improvement of rehabilitation outcomes. However, further higher-quality research is needed to confirm the observed positive effects