Mobile Health Monitoring

Chronic diseases impose heavy burden and costs on the health industry in many countries. Suitable health procedures, management, and prevention of disease by continuous monitoring through modern technologies can lead to a decrease in health costs and improve people empowerment. Applying remote medical diagnosis and monitoring system based on mobile health systems can help significantly reduce health care costs and correct performance management particularly in chronic disease management. In this chapter, mHealth opportunities in patient monitoring with the introduction of various systems specifically in chronic disease are expressed. Also mHealth challenges in patient monitoring in general and specific aspects are identified. Some of the general challenges include threats to confidentiality and privacy, and lack of information communication technology (ICT), and mobile infrastructure. In specific aspect, some difficulties include lack of system interoperability with electronic health records and other IT tools, decrease in face-to-face communication between doctor and patient, ill-functioning of system that leads to medical errors and negative effects on care outcomes, patients, and personnel, and factors related to the telecommunication industry include reliability and sudden interruptions of telecommunication networks

Telemedicine and natural disasters: various services, requirements, challenges, and general framework

Providing early health care services in natural disaster is one of the essential applications of telemedicine. This narrative review aims to investigate the applications, advantages and challenges of telemedicine in natural disaster-stricken areas. Medline (through PubMed), Web of Science (WOS), and Scopus databases were searched for related articles published from beginning to 2022. The keywords used for the search included "telemedicine" and "natural disaster." After removing duplicate papers, irrelevant review articles and letters to editors, 44 relevant papers were selected and reviewed. Information sharing through audio, visual, and data-oriented services is among critical approaches that telemedicine services mainly use. Teleconsultation, tele-education, remote interpretation, tele-psychiatry, and tele-surgery are among measures that can be implemented in emergencies like earthquakes, fires, floods, storms, and drought. The fundamental requirements of a telemedicine-oriented system for providing emergency services in natural disasters include wireless scales, conversation tools, blood pressure monitor, respiratory rate monitor, spo2 sensor, glucometer, portable ultrasound unit, wearable thermometers, virtual stethoscopes, portable three leads electrocardiograph monitor, and digital otoscopes. Simple telemedicine systems can have many advantages in the natural disasters. However, the main challenge in this regard is to adapt the necessary communication systems to a telemedicine paradigm. Another critical challenge is to interpret and apply the summary of acquired information and the inevitable interaction outcomes at the required time and place

Requirements for Designing a Wearable Smart Blanket System for Monitoring Patients in Ambulance

Introduction: Nowadays, smart systems and advanced tools such as wearable systems have grown significantly in order to monitor patients and keep their condition under control. The aim of this study was to determine the requirements for designing a wearable smart blanket system (WSBS) to monitor patients in ambulance instantaneously. Method: After reviewing the characteristics of wearable systems by conducting a comparative study, the requirements for designing the proposed system were determined using appropriate data collection methods. In the first step, studies were conducted to identify the requirements for the development of wearable systems, and in the second step, a questionnaire obtained from the studies was distributed among specialists, and based on the results obtained from the questionnaire, the requirements for designing the system were determined. Results: Wearable Smart Blanket System (WSBS) has special functional features such as monitoring of vital signs, ability to communicate with the environment, instantaneous processing of vital signs, the ability to alert when vital signs exceed the threshold, and the ability to record all the patients' vital signs. The main non-functional features of WSBS include easy installation and operation, interoperability, error tolerance, low power consumption, accuracy of signs recording, data evaluation and analysis. Conclusion: The WSBS records all the vital signs needed for the control of patients seamlessly and provides interpreted data for the ambulatory treatment team. All patients' medical, diagnostic, and monitored health information are stored in the physician assistants' system, and therefore, allows them to provide early diagnosis

Comparison of the effects of Duphaston and Cetrotide on oocyte and embryo quality in women undergoing ICSI: A cross-sectional study

Background: Premature luteinizing hormone (LH) surge is one of the causes for assisted reproductive technology cycle cancellation, and it is needed to find novel approaches with improved efficacy and safety profile. Objective: To compare the effects of Duphaston and Cetrotide on the prevention of premature LH surge and characteristics of retrieved follicles and embryos in women undergoing intracytoplasmic sperm injection. Materials and Methods: In this retrospective cross-sectional study, 200 patients who were administrated recombinant follicle-stimulating hormone from the third day of menstruation cycle were included. When the follicular diameter reached above 13-14 mm, Cetrotide was prescribed in the control group, while in the case group, Duphaston was taken orally from the third day of cycle. The retrieved oocytes were fertilized in vitro by intracytoplasmic sperm. The level of hormones on the third day of menstruation and the characteristic of follicles, oocytes, and embryos were compared between the two groups. Results: Duphaston successfully inhibits premature LH surge. There was no significant difference in the level of follicle-stimulating hormone, estradiol, and LH between the case and control groups (p > 0.05). However, results also showed that Duphaston causes more oocyte retrieval in comparison with Cetrotide (p = 0.04). Although, the number of follicles above 14 mm, mature oocyte, and the total number of viable embryos in the case group was slightly higher, it did not reach a significant difference compared with the control group (p > 0.05). Conclusion: Duphaston could be used as an appropriate medication instead of gonadotropin-releasing hormone antagonists in women undergoing controlled ovarian hyperstimulation. Duphaston prescription not only prevents premature LH surge but also improves the number of retrieved oocytes. Key words: Duphaston, Cetrorelix, Dydrogesterone, COH, GnRh antagonis

Clinical decision support system, a potential solution for diagnostic accuracy improvement in oral squamous cell carcinoma: A systematic review

BACKGROUND AND AIM: Oral squamous cell carcinoma (OSCC) is a rapidly progressive disease and despite the progress in the treatment of cancer, remains a life-threatening illness with a poor prognosis. Diagnostic techniques of the oral cavity are not painful, non-invasive, simple and inexpensive methods. Clinical decision support systems (CDSSs) are the most important diagnostic technologies used to help health professionals to analyze patients’ data and make decisions. This paper, by studying CDSS applications in the process of providing care for the cancer patients, has looked into the CDSS potentials in OSCC diagnosis. METHODS: We retrieved relevant articles indexed in MEDLINE/PubMed database using high-quality keywords. First, the title and then the abstract of the related articles were reviewed in the step of screening. Only research articles which had designed clinical decision support system in different stages of providing care for the cancer patient were retained in this study according to the input criteria. RESULTS: Various studies have been conducted about the important roles of CDSS in health processes related to different types of cancer. According to the aim of studies, we categorized them into several groups including treatment, diagnosis, risk assessment, screening, and survival estimation. CONCLUSION: Successful experiences in the field of CDSS applications in different types of cancer have indicated that machine learning methods have a high potential to manage the data and diagnostic improvement in OSCC intelligently and accurately. KEYWORDS: Squamous Cell Carcinoma; Clinical Decision Support System; Neoplasm; Dental Informatic

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

Faculty Members’ Evaluation by Students: Valid or Invalid

Introduction: Evaluation of university faculty members which is aimed to improve teaching quality is performed through several methods. One of the most common and conflicting methods is faculty evaluation by students. This method is commonly used in most universities in spite of controversy over its validity. This paper presents a glance at the current research literature on the viewpoints of faculty members toward their evaluation by students. Methods: This study is a literature review performed using library studies and electronic databases. First, 64 articles in the area of faculty member evaluation were studied. Out of these articles, 42 ones were selected which met the inclusion criteria. The inclusion criteria encompassed articles related to teacher evaluation, faculty members, and students’ viewpoints toward teaching approaches of faculties, teachers’ characteristics, classroom management, teachers’ communication skills and their relationship with students. Using the keywords of evaluation, student, faculty member, and university, we searched in journals such as Iranian Journal of Medical Education, Journal of Research and Planning in Higher Education, Knowledge and Research in Education, and other specialized journals in medical education area. Using scientific search engines such as Iran Medex, Magiran, SID, PubMed, Google Scholar, ISC, Medline, and Scopus the articles published or indexed between 1991 and 2010 were retrieved. Other papers which evaluated teachers and faculty members from other aspects or via other viewpoints were excluded. Results: The results were presented in three parts as “proponent to faculty evaluation by students”, “opponent”, and “teaching conditions affecting teacher evaluation by students”. The results showed that evaluation of teaching process must consider six aspects of content, students’ learning, classroom behavior, curriculum and materials, knowledge of faculty member, student characteristics (including material, students with high or low background, and postgraduate students), self-evaluation by the faculty member, evaluation by colleagues, educational administrators, and educational consultants and it must be compatible to organizational goals. Conclusion: The viewpoints of most faculty members of national universities and other countries states that they basically consider evaluation by their students as a valuable and reliable source of information for feedback to teachers in order to improve the quality of education. But, they believe that interventional factors should be identified and considered in this method. They also believed that teacher evaluation by students should be a part of comprehensive evaluation system of faculty members. But if the evaluation results are going to be utilized in commendation and promotion of faculty members, it would be better to employ other evaluation methods comprehensively

A Review of the Process of Meaningful Use Program and its Challenges in the Electronic Health Record Roadmap

Introduction: Meaningful use program indicates that health care organizations make meaningful use of an accredited electronic health record system. The objective of this study was to investigate the process of “meaningful use” program and the related challenges for the development of electronic health record. Method: This review study was conducted in 2020. The PubMed, Scopus, Science Direct, and Google scholar databases were searched from 2010 to October 2019 using “Meaningful Use Program” and “Electronic Health Record” as keywords. After applying the inclusion criteria, 20 articles were reviewed. Results: Based on the studies, the measures related to “Meaningful Use” program included 15 main measures, 5 selected sub-measures, and 6 qualitative clinical measures. The program includes three steps: data recording and sharing, advanced clinical processes, and improving health outcomes. The primary criteria for receiving the incentive amount of “Meaningful Use” program included computerized physician order entry, investigation of drug interactions, creation of electronic prescriptions, and registration of demographic characteristics. The challenges of this program included the time-consuming nature of the program, the lack of control over infrastructure development, unusable technologies of electronic health records, and the all-or-nothing approach to certification. Conclusion: The use of new programs and solutions like “Meaningful Use” program can lead to the development of electronic health record and enables more secure exchange of information

Design and Evaluation of a Wearable Smart Blanket System for Monitoring Vital Signs of Patients in an Ambulance

Objectives. Considering the advantages of the wearable systems (such as continuous monitoring, ease of installation, and significant efficiency), they can also be used to monitor patients in emergency situations and, particularly, in the ambulance. This study is aimed at specifying, modeling, and evaluating a wearable smart blanket system for monitoring vital signs in emergency circumstances. Method. At first, all the smart blanket system requirements were specified using an author-made questionnaire, and the essential requirements were specified in the software requirements specification format. Such an anticipated smart wearable blanket is then modeled by Unified Modeling Language. Finally, the most important quality attributes (i.e., the nonfunctional requirements) of the proposed wearable smart blanket system were evaluated using a descriptive-analytical study. Results. Evaluation results of the proposed system show that using the smart blanket system could not only provide the required functionalities, but also, it improved the important quality attributes such as response time and delay in sending data packets (14% improvement), accuracy, energy consumption (18% improvement), reliability and fault-tolerance, and performance (28% improvement) in contrast to the compared related work. Conclusion. Using a smart wearable blanket in an ambulance instead of such in a huge ambulance cabin would be beneficial in terms of time and space, ease of use, and maybe cost while providing the required functionalities besides having proper quality attributes

Self-Care Application for Rheumatoid Arthritis: Identifying Key Data Elements

Introduction: Rheumatoid arthritis is a systemic, chronic autoimmune disease that affects the joints, and limited mobility. The disease is progressive and can significantly impact a patient's quality of life. Today, mobile applications have the potential to address specific health needs and provide therapeutic interventions. The initial stage of constructing and advancing a healthcare information system involves the utilization of a minimum data set, which comprises essential and standardized data components aimed at capturing and overseeing patient care. This study aims to identify key components for a mobile-based self-care application for patients with rheumatoid arthritis. Material and Methods: In this descriptive analytical study, two steps were undertaken. Firstly, a review of related articles and existing apps was conducted. Secondly, a researcher-developed questionnaire with a high reliability coefficient (Cronbach's alpha=0.97) was used to validate the identified information elements. Elements that scored at least an average of 3.2 (60%) on a 5 point Likert scale were deemed necessary data components for the design of an android-based mobile app catering to the self-care needs of rheumatoid arthritis patients. Results: Based on the analysis findings, experts identified crucial technical requirements for a mobile-based self-management system. The system should include features for documenting drug side effects and providing educational content and physical exercise videos. Additionally, these requirements encompass reminders for medication, doctor appointments, and physical activities. Priorities also include clinical information, lifestyle management, and patient demographics. Conclusion: Overall, the implementation of such a system has the potential to enhance patients' self-management skills, promote active involvement in self-care, and facilitate communication with healthcare providers