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1.
PLoS One ; 16(3): e0248128, 2021.
Article in English | MEDLINE | ID: covidwho-1575679

ABSTRACT

BACKGROUND: The COVID-19 pandemic remains a significant global threat. However, despite urgent need, there remains uncertainty surrounding best practices for pharmaceutical interventions to treat COVID-19. In particular, conflicting evidence has emerged surrounding the use of hydroxychloroquine and azithromycin, alone or in combination, for COVID-19. The COVID-19 Evidence Accelerator convened by the Reagan-Udall Foundation for the FDA, in collaboration with Friends of Cancer Research, assembled experts from the health systems research, regulatory science, data science, and epidemiology to participate in a large parallel analysis of different data sets to further explore the effectiveness of these treatments. METHODS: Electronic health record (EHR) and claims data were extracted from seven separate databases. Parallel analyses were undertaken on data extracted from each source. Each analysis examined time to mortality in hospitalized patients treated with hydroxychloroquine, azithromycin, and the two in combination as compared to patients not treated with either drug. Cox proportional hazards models were used, and propensity score methods were undertaken to adjust for confounding. Frequencies of adverse events in each treatment group were also examined. RESULTS: Neither hydroxychloroquine nor azithromycin, alone or in combination, were significantly associated with time to mortality among hospitalized COVID-19 patients. No treatment groups appeared to have an elevated risk of adverse events. CONCLUSION: Administration of hydroxychloroquine, azithromycin, and their combination appeared to have no effect on time to mortality in hospitalized COVID-19 patients. Continued research is needed to clarify best practices surrounding treatment of COVID-19.


Subject(s)
Antiviral Agents/therapeutic use , Azithromycin/therapeutic use , COVID-19/drug therapy , Hydroxychloroquine/therapeutic use , Pandemics/prevention & control , Data Management/methods , Drug Therapy, Combination/methods , Female , Hospitalization , Humans , Male , SARS-CoV-2/drug effects
2.
J Public Health Manag Pract ; 28(1): E16-E22, 2022.
Article in English | MEDLINE | ID: covidwho-1526219

ABSTRACT

Disease investigation and contact tracing are long-standing public health strategies used to control the spread of infectious disease. Throughout the COVID-19 pandemic, health departments across the country have lacked the internal workforce capacity and technology needed to efficiently isolate positive cases and quarantine close contacts to slow the spread of SARS-CoV-2. This article describes an innovative disease investigation and contact tracing program developed through a formalized community partnership between a local county health department and local university. This innovative new program added 108 contact tracers to the county's public health workforce, as well as enabled these contact tracers to work remotely using a call center app and secure cloud-based platform to manage the county's caseload of cases and contacts. An overview of the requirements needed to develop this program (eg, hiring, health data security protocols, data source management), as well as lessons learned is discussed.


Subject(s)
COVID-19 , Pandemics , Contact Tracing , Data Management , Humans , Pandemics/prevention & control , SARS-CoV-2
3.
PLoS One ; 16(11): e0259514, 2021.
Article in English | MEDLINE | ID: covidwho-1502075

ABSTRACT

INTRODUCTION: Famotidine is a competitive histamine H2-receptor antagonist most commonly used for gastric acid suppression but thought to have potential efficacy in treating patients with Coronavirus disease 2019 (COVID-19). The aims of this systematic review and meta-analysis are to summarize the current literature and report clinical outcomes on the use of famotidine for treatment of hospitalized patients with COVID-19. METHODS: Five databases were searched through February 12, 2021 to identify observational studies that reported on associations of famotidine use with outcomes in COVID-19. Meta-analysis was conducted for composite primary clinical outcome (e.g. rate of death, intubation, or intensive care unit admissions) and death separately, where either aggregate odds ratio (OR) or hazard ratio (HR) was calculated. RESULTS: Four studies, reporting on 46,435 total patients and 3,110 patients treated with famotidine, were included in this meta-analysis. There was no significant association between famotidine use and composite outcomes in patients with COVID-19: HR 0.63 (95% CI: 0.35, 1.16). Across the three studies that reported mortality separated from other endpoints, there was no association between famotidine use during hospitalization and risk of death-HR 0.67 (95% CI: 0.26, 1.73) and OR 0.79 (95% CI: 0.19, 3.34). Heterogeneity ranged from 83.69% to 88.07%. CONCLUSION: Based on the existing observational studies, famotidine use is not associated with a reduced risk of mortality or combined outcome of mortality, intubation, and/or intensive care services in hospitalized individuals with COVID-19, though heterogeneity was high, and point estimates suggested a possible protective effect for the composite outcome that may not have been observed due to lack of power. Further randomized controlled trials (RCTs) may help determine the efficacy and safety of famotidine as a treatment for COVID-19 patients in various care settings of the disease.


Subject(s)
COVID-19/drug therapy , Famotidine/therapeutic use , Hospitalization , Adult , Aged , Data Management , Female , Histamine H2 Antagonists/therapeutic use , Humans , Male , Middle Aged , Observational Studies as Topic , Odds Ratio , Proportional Hazards Models , Randomized Controlled Trials as Topic , Risk , SARS-CoV-2
4.
Int J Environ Res Public Health ; 18(21)2021 10 30.
Article in English | MEDLINE | ID: covidwho-1488593

ABSTRACT

To counteract the COVIC-19 pandemic, many governments have introduced social distancing measures. While these restrictions helped contain the virus, it had adverse effects on individuals' mental and physical health-especially children. The aim of the present study is to review the evidence on the effects of COVID-19 restrictions on children's physical activity and their determinants. A scoping review was conducted in the databases PubMed, Web of Science, SportDiscus, and BISp-Surf. Inclusion criteria were empirical and peer-reviewed studies, youth samples, investigation of COVID-19 restrictions, and investigating changes and/or determinants of physical activity before and during the COVID-19 pandemic. Risk of bias was assessed using the checklist by Downs and Black. The search resulted in 1672 studies, of which 84 studies were included in the analysis. The results highlighted a decrease in physical activity during the pandemic, ranging between -10.8 min/day and -91 min/day. If an increase was detected, it related to unstructured and outdoor activities. The main determinants of children's physical activity during the pandemic were age, gender, socioeconomic background, and the outdoor environment. The results imply that governments need to consider the negative effects that restrictive measures have on children's physical activity and act to ensure high levels of physical activity.


Subject(s)
COVID-19 , Pandemics , Adolescent , Child , Data Management , Exercise , Humans , SARS-CoV-2
5.
PLoS One ; 16(7): e0254445, 2021.
Article in English | MEDLINE | ID: covidwho-1456077

ABSTRACT

BACKGROUND: Many women stop breastfeeding before they intend to as they cannot overcome breastfeeding difficulties. Breastfeeding support, as an evidence-based intervention by trained lay or professional breastfeeding support providers, can prevent early unintended cessation. Yet some women report dissatisfaction with support and reluctantly stop breastfeeding despite receiving this intervention. Understanding the experiences which shape how support is provided can inform effective implementation of breastfeeding support interventions. This review aims to synthesise experiences of trained breastfeeding support providers in high income settings and how these may influence their breastfeeding support practices. METHODS: A qualitative systematic review of trained breastfeeding supporters' experiences of supporting women to breastfeed, as part of a generic healthcare role or focused breastfeeding support role, will be conducted. A systematic search will be performed of the databases: Cumulative Index to Nursing and Allied Health Literature (CINAHL +), MEDLINE ALL, Maternity and Infant Care, EMBASE, APA PsycINFO, Web of Science and Scopus. Title and abstract screening using eligibility criteria will be conducted using Covidence software. Eligible papers will be agreed by the review team following full text screening and reported using PRISMA guidelines. CASP and COREQ tools will assess study methodological quality and quality of reporting. Data will be extracted using a bespoke form and coded, using Excel software for data management. Analysis will involve the three stages of thematic synthesis: initial free coding, development of descriptive and subsequent analytical themes. Confidence in findings will be assessed using the CERQual framework. DISCUSSION: This review is the first to date to synthesise qualitative evidence on experiences which influence how trained lay and professional providers support women with breastfeeding. Findings will enable deeper understanding of the underpinning mechanisms of breastfeeding support provision and inform the development of tailored interventions to improve breastfeeding rates. SYSTEMATIC REVIEW REGISTRATION: PROSPERO registration number: CRD42020207380.


Subject(s)
Breast Feeding , Qualitative Research , Data Management , Delivery of Health Care , Female , Humans , Postnatal Care , Pregnancy
6.
Medicine (Baltimore) ; 100(38): e22571, 2021 Sep 24.
Article in English | MEDLINE | ID: covidwho-1437852

ABSTRACT

BACKGROUND: There are few reports on the chest computed tomography (CT) imaging features of children with coronavirus disease 2019 (COVID-19), and most reports involve small sample sizes. OBJECTIVES: To systematically analyze the chest CT imaging features of children with COVID-19 and provide references for clinical practice. DATA SOURCES: We searched PubMed, Web of Science, and Embase; data published by Johns Hopkins University; and Chinese databases CNKI, Wanfang, and Chongqing Weipu. METHODS: Reports on chest CT imaging features of children with COVID-19 from January 1, 2020 to August 10, 2020, were analyzed retrospectively and a meta-analysis carried out using Stata12.0 software. RESULTS: Thirty-seven articles (1747 children) were included in this study. The heterogeneity of meta-analysis results ranged from 0% to 90.5%. The overall rate of abnormal lung CT findings was 63.2% (95% confidence interval [CI]: 55.8%-70.6%), with a rate of 61.0% (95% CI: 50.8%-71.2%) in China and 67.8% (95% CI: 57.1%-78.4%) in the rest of the world in the subgroup analysis. The incidence of ground-glass opacities was 39.5% (95% CI: 30.7%-48.3%), multiple lung lobe lesions was 65.1% (95% CI: 55.1%-67.9%), and bilateral lung lesions was 61.5% (95% CI: 58.8%-72.2%). Other imaging features included nodules (25.7%), patchy shadows (36.8%), halo sign (24.8%), consolidation (24.1%), air bronchogram signs (11.2%), cord-like shadows (9.7%), crazy-paving pattern (6.1%), and pleural effusion (9.1%). Two articles reported 3 cases of white lung, another reported 2 cases of pneumothorax, and another 1 case of bullae. CONCLUSIONS: The lung CT results of children with COVID-19 are usually normal or slightly atypical. The lung lesions of COVID-19 pediatric patients mostly involve both lungs or multiple lobes, and the common manifestations are patchy shadows, ground-glass opacities, consolidation, partial air bronchogram signs, nodules, and halo signs; white lung, pleural effusion, and paving stone signs are rare. Therefore, chest CT has limited value as a screening tool for children with COVID-19 and can only be used as an auxiliary assessment tool.


Subject(s)
COVID-19/diagnostic imaging , Lung/diagnostic imaging , Thorax/diagnostic imaging , Tomography, X-Ray Computed/statistics & numerical data , Adolescent , Blister/diagnostic imaging , Blister/epidemiology , Blister/virology , COVID-19/diagnosis , COVID-19/epidemiology , COVID-19/virology , Child , Child, Preschool , Data Management , Female , Humans , Incidence , Infant , Lung/pathology , Lung/virology , Male , Pleural Effusion/diagnostic imaging , Pleural Effusion/epidemiology , Pleural Effusion/virology , Pneumothorax/diagnostic imaging , Pneumothorax/epidemiology , Retrospective Studies , SARS-CoV-2/genetics , Solitary Pulmonary Nodule/diagnostic imaging , Solitary Pulmonary Nodule/epidemiology , Solitary Pulmonary Nodule/virology , Tomography, X-Ray Computed/methods , Tomography, X-Ray Computed/trends
7.
PLoS One ; 16(9): e0257093, 2021.
Article in English | MEDLINE | ID: covidwho-1435606

ABSTRACT

OBJECTIVE: To evaluate the reporting quality of randomized controlled trials (RCTs) regarding patients with COVID-19 and analyse the influence factors. METHODS: PubMed, Embase, Web of Science and the Cochrane Library databases were searched to collect RCTs regarding patients with COVID-19. The retrieval time was from the inception to December 1, 2020. The CONSORT 2010 statement was used to evaluate the overall reporting quality of these RCTs. RESULTS: 53 RCTs were included. The study showed that the average reporting rate for 37 items in CONSORT checklist was 53.85% with mean overall adherence score of 13.02±3.546 (ranged: 7 to 22). The multivariate linear regression analysis showed the overall adherence score to the CONSORT guideline was associated with journal impact factor (P = 0.006), and endorsement of CONSORT statement (P = 0.014). CONCLUSION: Although many RCTs of COVID-19 have been published in different journals, the overall reporting quality of these articles was suboptimal, it can not provide valid evidence for clinical decision-making and systematic reviews. Therefore, more journals should endorse the CONSORT statement, authors should strictly follow the relevant provisions of the CONSORT guideline when reporting articles. Future RCTs should particularly focus on improvement of detailed reporting in allocation concealment, blinding and estimation of sample size.


Subject(s)
COVID-19/epidemiology , Publications/standards , Publishing/standards , Randomized Controlled Trials as Topic/standards , Data Management/standards , Guideline Adherence/standards , Humans , Journal Impact Factor , PubMed/standards , SARS-CoV-2/pathogenicity
8.
J Med Internet Res ; 23(10): e28613, 2021 10 28.
Article in English | MEDLINE | ID: covidwho-1417034

ABSTRACT

BACKGROUND: As a distributed technology, blockchain has attracted increasing attention from stakeholders in the medical industry. Although previous studies have analyzed blockchain applications from the perspectives of technology, business, or patient care, few studies have focused on actual use-case scenarios of blockchain in health care. In particular, the outbreak of COVID-19 has led to some new ideas for the application of blockchain in medical practice. OBJECTIVE: This paper aims to provide a systematic review of the current and projected uses of blockchain technology in health care, as well as directions for future research. In addition to the framework structure of blockchain and application scenarios, its integration with other emerging technologies in health care is discussed. METHODS: We searched databases such as PubMed, EMBASE, Scopus, IEEE, and Springer using a combination of terms related to blockchain and health care. Potentially relevant papers were then compared to determine their relevance and reviewed independently for inclusion. Through a literature review, we summarize the key medical scenarios using blockchain technology. RESULTS: We found a total of 1647 relevant studies, 60 of which were unique studies that were included in this review. These studies report a variety of uses for blockchain and their emphasis differs. According to the different technical characteristics and application scenarios of blockchain, we summarize some medical scenarios closely related to blockchain from the perspective of technical classification. Moreover, potential challenges are mentioned, including the confidentiality of privacy, the efficiency of the system, security issues, and regulatory policy. CONCLUSIONS: Blockchain technology can improve health care services in a decentralized, tamper-proof, transparent, and secure manner. With the development of this technology and its integration with other emerging technologies, blockchain has the potential to offer long-term benefits. Not only can it be a mechanism to secure electronic health records, but blockchain also provides a powerful tool that can empower users to control their own health data, enabling a foolproof health data history and establishing medical responsibility.


Subject(s)
Blockchain , COVID-19 , Confidentiality , Data Management , Electronic Health Records , Humans , SARS-CoV-2
9.
Int J Environ Res Public Health ; 18(17)2021 08 26.
Article in English | MEDLINE | ID: covidwho-1403584

ABSTRACT

In the case of rapid outbreaks of infectious diseases in remote locations, the lack of real-time information from the field and rapid spread of misinformation can be a major issue. To improve situational awareness and decision-making at all levels of operational deployment, there is an urgent need for accurate, reliable, and timely results from patients from the affected area. This requires a robust and fast channel of communication connecting first responders on-site, crisis managers, decision-makers, and the institutions involved in the survey of the crisis at national, regional, and international levels. This has been the rationale sustaining the development of advanced communication tools in the Biological Light Fieldable Laboratory for Emergencies (B-LiFE). The benefit of terrestrial (TETRA, LTE, 5G, and Wi-Fi-Fi) and SatCom communications is illustrated through a series of missions and exercises conducted in the previous five years. These tools were used by B-LiFE operators to provide accurate, comprehensive, timely, and relevant information and services in real time. The focus of this article is to discuss the development and benefits of the integration of multi-mission, multi-user nomadic, rapidly deployable telecommunication nodes for emergency uses (TEN) in the capacity of B-LiFE. Providing reliable communication channels through TEN enables the development and use of an ICT toolbox called MIML_LIMS (multi-institution, multi-mission, multi-laboratory LIMS), a tool which is mandatory for efficient and secure data management and data sharing by a mobile laboratory.


Subject(s)
Data Management , Telecommunications , Humans , Information Dissemination , Laboratories , Public Health
10.
Medicine (Baltimore) ; 100(35): e26972, 2021 Sep 03.
Article in English | MEDLINE | ID: covidwho-1393505

ABSTRACT

ABSTRACT: There are no standardized methods for collecting and reporting coronavirus disease-2019 (COVID-19) data. We aimed to compare the proportion of patients admitted for COVID-19-related symptoms and those admitted for other reasons who incidentally tested positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).Retrospective cohort studyData were sampled twice weekly between March 26 and June 6, 2020 from a "COVID-19 dashboard," a system-wide administrative database that includes the number of hospitalized patients with a positive SARS-CoV-2 polymerase chain reaction test. Patient charts were subsequently reviewed and the principal reason for hospitalization abstracted.Data collected during a statewide lockdown revealed that 92 hospitalized patients had positive SARS-CoV-2 test results. Among these individuals, 4.3% were hospitalized for reasons other than COVID-19-related symptoms but were incidentally found to be SARS-CoV-2-positive. After the lockdown was suspended, the total inpatient census of SARS-CoV-2-positive patients increased to 128, 20.3% of whom were hospitalized for non-COVID-19-related complaints.In the absence of a statewide lockdown, there was a significant increase in the proportion of patients admitted for non-COVID-19-related complaints who were incidentally found to be SARS-CoV-2-positive. In order to ensure data integrity, coding should distinguish between patients with COVID-19-related symptoms and asymptomatic patients carrying the SARS-CoV-2 virus.


Subject(s)
Asymptomatic Infections/epidemiology , COVID-19/epidemiology , Data Management/standards , Hospitalization/statistics & numerical data , COVID-19 Nucleic Acid Testing/statistics & numerical data , Female , Humans , Incidental Findings , Male , Pandemics , Quality Improvement , Retrospective Studies , SARS-CoV-2 , Trust
11.
Cytometry A ; 99(1): 60-67, 2021 01.
Article in English | MEDLINE | ID: covidwho-1384157

ABSTRACT

Data management is essential in a flow cytometry (FCM) shared resource laboratory (SRL) for the integrity of collected data and its long-term preservation, as described in the Cytometry publication from 2016, ISAC Flow Cytometry Shared Resource Laboratory (SRL) Best Practices (Barsky et al.: Cytometry Part A 89A(2016): 1017-1030). The SARS-CoV-2 pandemic introduced an array of challenges in the operation of SRLs. The subsequent laboratory shutdowns and access restrictions brought to the forefront well-established practices that withstood the impact of a sudden change in operations and illuminated areas that need improvement. The most significant challenges from a data management perspective were data access for remote analysis and workstation management. Notably, lessons learned from this challenge emphasize the importance of safeguarding collected data from loss in various emergencies such as fire or natural disasters where the physical hardware storing data could be directly affected. Here, we describe two data management systems that have been successful during the current emergency created by the pandemic, specifically remote access and automated data transfer. We will discuss other situations that could arise and lead to data loss or challenges in interpreting data. © 2020 International Society for Advancement of Cytometry.


Subject(s)
COVID-19/epidemiology , Data Management/trends , Flow Cytometry/trends , Laboratories/trends , Teleworking/trends , COVID-19/prevention & control , Data Management/standards , Flow Cytometry/standards , Humans , Laboratories/standards , Teleworking/standards
12.
PLoS One ; 16(8): e0255417, 2021.
Article in English | MEDLINE | ID: covidwho-1341503

ABSTRACT

Due to the sheer number of COVID-19 (coronavirus disease 2019) cases there is a need for increased world-wide SARS-CoV-2 testing capability that is both efficient and effective. Having open and easy access to detailed information about these tests, their sensitivity, the types of samples they use, etc. would be highly useful to ensure their reproducibility, to help clients compare and decide which tests would be best suited for their applications, and to avoid costs of reinventing similar or identical tests. Additionally, this resource would provide a means of comparing the many innovative diagnostic tools that are currently being developed in order to provide a foundation of technologies and methods for the rapid development and deployment of tests for future emerging diseases. Such a resource might thus help to avert the delays in testing and screening that was observed in the early stages of the pandemic and plausibly led to more COVID-19-related deaths than necessary. We aim to address these needs via a relational database containing standardized ontology and curated data about COVID-19 diagnostic tests that have been granted Emergency Use Authorizations (EUAs) by the FDA (US Food and Drug Administration). Simple queries of this actively growing database demonstrate considerable variation among these tests with respect to sensitivity (limits of detection, LoD), controls and targets used, criteria used for calling results, sample types, reagents and instruments, and quality and amount of information provided.


Subject(s)
COVID-19 Testing , Databases, Factual , Emergencies , United States Food and Drug Administration/organization & administration , COVID-19/diagnosis , COVID-19 Testing/methods , COVID-19 Testing/standards , Data Management/organization & administration , Data Management/standards , Databases, Factual/supply & distribution , Emergencies/classification , Emergency Treatment/classification , Emergency Treatment/methods , Humans , Internet , Laboratories/standards , Reference Standards , Sensitivity and Specificity , United States , User-Computer Interface
14.
PLoS One ; 16(7): e0255520, 2021.
Article in English | MEDLINE | ID: covidwho-1332017

ABSTRACT

BACKGROUND: The pandemic of coronavirus disease (COVID-19) has greatly changed people's daily lives, forcing countries to take actions, such as school shutdown, lockdown, isolation, and social distancing measures. It remains unclear how the closures, cancellations, and restrictions of schools and courses as a response to the COVID-19 pandemic affect the engagement of school-aged children and adolescents in relation to physical activity (PA). METHODS: The articles in the databases of EBSCO (including AMED, CINAHL Plus, Health Business, Health Source MEDLINE with Full Text, APA PsycArticles, APA PsycINFO, and SPORTDiscus) published during the period from 1 January 2020 to 31 December 2020 will be retrieved, and the data in the selected articles are extracted, including research methods, demographics, and key results. Search outcomes were reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The Mixed Methods Appraisal Tool (MMAT) will be used to evaluate research quality. Two reviewers are responsible for completing the three tasks, namely selecting the articles that meet the inclusion criteria, extracting data in the articles selected, and evaluating their research quality. All findings, and especially primary outcomes will be summarized in a table format of findings. The results will provide a high-quality synthesis of current evidence for researchers in this subject area. AIM: The objective of this systematic review is to investigate the effects of the COVID-19 pandemic on PA in children and adolescents aged 6-17 years during 2020. 1). What impact has the COVID-19 pandemic had on PA levels in school-aged children and adolescents? 2). Investigating changes in the locations of school-aged children's and adolescents' PA between the pre-COVID-19 period (January 2020) and the COVID-19 period (December 2020). RESULTS: We hope that this study will provide government authorities and health professionals with the necessary information in guiding actions and allocating resources, so that the situation of physical inactivity in school-aged children and adolescents during the COVID-19 pandemic can be improved, thereby enhancing their physical health. PROTOCOL REGISTRATION NUMBER: This review was submitted and registered under CRD42020225976 in PROSPERO.


Subject(s)
COVID-19/physiopathology , Exercise/physiology , Pandemics/prevention & control , Adolescent , Child , Data Management/methods , Humans , Schools , Sedentary Behavior
15.
BMJ Health Care Inform ; 28(1)2021 Jul.
Article in English | MEDLINE | ID: covidwho-1304225

ABSTRACT

OBJECTIVES: A customised data management system was required for a rapidly implemented COVID-19-adapted colorectal cancer pathway in order to mitigate the risks of delayed and missed diagnoses during the pandemic. We assessed its performance and robustness. METHODS: A system was developed using Microsoft Excel (2007) to retain the spreadsheets' intuitiveness of direct data entry. Visual Basic for Applications (VBA) was used to construct a user-friendly interface to enhance efficiency of data entry and segregate the data for operational tasks. RESULTS: Large data segregation was possible using VBA macros. Data validation and conditional formatting minimised data entry errors. Computation by the COUNT function facilitated live data monitoring. CONCLUSION: It is possible to rapidly implement a makeshift database system with clinicians' regular input. Large-volume data management using a spreadsheet system is possible with appropriate data definition and VBA-programmed data segregation. The described concept is applicable to any data management system construction requiring speed and flexibility in a resource-limited situation.


Subject(s)
COVID-19 , Colorectal Neoplasms , Critical Pathways , Data Management , Colorectal Neoplasms/prevention & control , Databases, Factual , Early Detection of Cancer , Humans , Software , Time Factors , User-Computer Interface
16.
Sci Rep ; 11(1): 11974, 2021 06 07.
Article in English | MEDLINE | ID: covidwho-1260946

ABSTRACT

The efficacy and safety of Hydroxychloroquine (HCQ) in treating coronavirus disease (COVID-19) is disputed. This systematic review and meta-analysis aimed to examine the efficacy and safety of HCQ in addition to standard of care (SOC) in COVID-19. PubMed, the Cochrane Library, Embase, Web of sciences, and medRxiv were searched up to March 15, 2021. Clinical studies registry databases were also searched for identifying potential clinical trials. The references list of the key studies was reviewed to identify additional relevant resources. The quality of the included studies was evaluated using the Cochrane Collaboration tool and Jadad checklist. Meta-analysis was performed using RevMan software (version 5.3). Eleven randomized controlled trials with a total number of 8161 patients were identified as eligible for meta-analysis. No significant differences were observed between the two treatment groups in terms of negative rate of polymerase chain reaction (PCR) (Risk ratio [RR]: 0.99, 95% confidence interval (CI) 0.90, 1.08; P = 0.76), PCR negative conversion time (Mean difference [MD]: - 1.06, 95% CI - 3.10, 0.97; P = 0.30), all-cause mortality (RR: 1.09, 95% CI 1.00, 1.20; P = 0.06), body temperature recovery time (MD: - 0.64, 95% CI - 1.37, 0.10; P = 0.09), length of hospital stay (MD: - 0.17, 95% CI - 0.80, 0.46; P = 0.59), use of mechanical ventilation (RR: 1.12, 95% CI 0.95, 1.32; P = 0.19), and disease progression (RR = 0.82, 95% CI 0.37, 1.85; P = 0.64). However, there was a significant difference between two groups regarding adverse events (RR: 1.81, 95% CI 1.36, 2.42; P < 0.05). The findings suggest that the addition of HCQ to SOC has no benefit in the treatment of hospitalized patients with COVID-19. Additionally, it is associated with more adverse events.


Subject(s)
Antiviral Agents/therapeutic use , COVID-19/drug therapy , Hydroxychloroquine/therapeutic use , Standard of Care , Data Management , Humans , Hydroxychloroquine/adverse effects , Randomized Controlled Trials as Topic , SARS-CoV-2/pathogenicity , Treatment Outcome
17.
J Public Health Policy ; 42(2): 211-221, 2021 Jun.
Article in English | MEDLINE | ID: covidwho-1258617

ABSTRACT

In order to effectively control spread of coronavirus 2019 (COVID-19), it is essential that jurisdictions have the capacity to rapidly trace close contacts of each and every case. Best practice guidance on how to implement such programs is urgently needed. We describe the early experience in the City and County of San Francisco (CCSF), where the City's Department of Health expanded contact tracing capability in anticipation of changes in San Francisco's 'shelter in place' order between April and June 2020. Important prerequisites to successful scale-up included a rapid expansion of the COVID-19 response workforce, expansion of testing capability, and other containment resources. San Francisco's scale-up offers a model for how other jurisdictions can rapidly mobilize a workforce. We underscore the importance of an efficient digital case management system, effective training, and expansion of supportive service programs for those in quarantine or isolation, and metrics to ensure continuous performance improvement.


Subject(s)
COVID-19/epidemiology , COVID-19/prevention & control , Contact Tracing/methods , Public Health Administration/methods , COVID-19/diagnosis , COVID-19 Testing/statistics & numerical data , Data Management/organization & administration , Efficiency, Organizational , Humans , Pandemics , Quarantine/psychology , SARS-CoV-2 , San Francisco/epidemiology , Social Work/organization & administration
18.
PLoS One ; 16(5): e0252409, 2021.
Article in English | MEDLINE | ID: covidwho-1247664

ABSTRACT

The use of telemedicine in ICUs has grown and is becoming increasingly recognized. However, its impact on PICUs remains unclear. This systematic review and meta-analysis aimed to evaluate whether telemedicine in the PICU has the potential to improve clinical and non-clinical outcomes. PubMed, Scopus, LILACS, and CINAHL electronic databases were searched to identify studies that assessed the impact of telemedicine on clinical outcomes, with no publication date restrictions. The reference lists of the selected articles were hand-searched for additional studies that had not been identified by the initial electronic search. Studies were included if they had a cohort design, used telemedicine, were conducted in PICUs or specialized PICUs, and were published in Portuguese, English, or Spanish. Two groups of reviewers independently screened titles and abstracts for inclusion. The same group of reviewers independently assessed the full-text articles for eligibility and extracted the following information: telecommunication method, intervention characteristics, patient characteristics, sample size, and main results. Studies were meta-analyzed using a random-effects model to estimate the pooled prevalence of PICU mortality and length of PICU stay. Risk of bias was assessed using the Newcastle-Ottawa Scale. Of 2703 studies initially identified, 2226 had their titles and abstracts screened. Of these, 53 were selected for full-text reading, of which 10 were included and analyzed. The main results of interest were length of PICU stay, number of deaths or mortality rate, and satisfaction of health professionals and family members. The results of meta-analysis show that the mortality rate reduced by 34% with an increase of the length of PICU stay in the PICUs with the use of telemedicine. Family members and health professionals were satisfied with the use of telemedicine. Telemedicine has the potential to improve PICU outcomes, such as mortality rate and family and staff satisfaction. However, it extended length of PICU stay in the studies included in this systematic review.


Subject(s)
Telemedicine/methods , Data Management , Humans
19.
J Am Med Inform Assoc ; 28(8): 1605-1611, 2021 07 30.
Article in English | MEDLINE | ID: covidwho-1228522

ABSTRACT

OBJECTIVE: The rapidly evolving COVID-19 pandemic has created a need for timely data from the healthcare systems for research. To meet this need, several large new data consortia have been developed that require frequent updating and sharing of electronic health record (EHR) data in different common data models (CDMs) to create multi-institutional databases for research. Traditionally, each CDM has had a custom pipeline for extract, transform, and load operations for production and incremental updates of data feeds to the networks from raw EHR data. However, the demands of COVID-19 research for timely data are far higher, and the requirements for updating faster than previous collaborative research using national data networks have increased. New approaches need to be developed to address these demands. METHODS: In this article, we describe the use of the Fast Healthcare Interoperability Resource (FHIR) data model as a canonical data model and the automated transformation of clinical data to the Patient-Centered Outcomes Research Network (PCORnet) and Observational Medical Outcomes Partnership (OMOP) CDMs for data sharing and research collaboration on COVID-19. RESULTS: FHIR data resources could be transformed to operational PCORnet and OMOP CDMs with minimal production delays through a combination of real-time and postprocessing steps, leveraging the FHIR data subscription feature. CONCLUSIONS: The approach leverages evolving standards for the availability of EHR data developed to facilitate data exchange under the 21st Century Cures Act and could greatly enhance the availability of standardized datasets for research.


Subject(s)
Biomedical Research/organization & administration , COVID-19 , Data Warehousing , Electronic Health Records , Health Information Interoperability , Information Dissemination , Common Data Elements , Data Management/organization & administration , Humans
20.
Bioethics ; 35(6): 581-588, 2021 07.
Article in English | MEDLINE | ID: covidwho-1216724

ABSTRACT

The COVID-19 pandemic has had an immense and worldwide impact. In light of future pandemics or subsequent waves of COVID-19 it is crucial to focus on the ethical issues that were and still are raised in this COVID-19 crisis. In this paper, we look at issues that are raised in the testing and tracing of patients with COVID-19. We do this by highlighting and expanding on an approach suggested by Fineberg that could serve as a public health approach. In this way, we highlight several ethical issues. As regards testing, questions are raised such as whether it is ethical to use less reliable tests in order to increase testing capacity or minimize harm for patients. Another issue is how wide testing should be and whether selective testing is in accordance with principles of social justice. Patients who have recovered from COVID-19 might have some degree of immunity but attributing certain 'immunopriviliges' raises ethical questions. The use of various tracing methodologies (mobile apps or databases and trained tracers) raised evident questions of social justice and privacy. We argue why it is key to always uphold a test of proportionality where a fair balance must be sought.


Subject(s)
COVID-19 Testing/ethics , COVID-19 , Contact Tracing/ethics , Ethics , Mass Screening/ethics , Pandemics , Public Health/ethics , COVID-19/diagnosis , COVID-19/prevention & control , Contact Tracing/methods , Data Management , Humans , Mobile Applications , Privacy , Reproducibility of Results , SARS-CoV-2 , Social Justice
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