Clinical decision support systems (CDSS) in assistance to COVID-19 diagnosis: A scoping review on types and evaluation methods.

Background and Aims: Due to the COVID-19 pandemic, a precise and reliable diagnosis of this disease is critical. The use of clinical decision support systems (CDSS) can help facilitate the diagnosis of COVID-19. This scoping review aimed to investigate the role of CDSS in diagnosing COVID-19. Methods: We searched four databases (Web of Science, PubMed, Scopus, and Embase) using three groups of keywords related to CDSS, COVID-19, and diagnosis. To collect data from studies, we utilized a data extraction form that consisted of eight fields. Three researchers selected relevant articles and extracted data using a data collection form. To resolve any disagreements, we consulted with a fourth researcher. Results: A search of the databases retrieved 2199 articles, of which 68 were included in this review after removing duplicates and irrelevant articles. The studies used nonknowledge-based CDSS (n = 52) and knowledge-based CDSS (n = 16). Convolutional Neural Networks (CNN) (n = 33) and Support Vector Machine (SVM) (n = 8) were employed to design the CDSS in most of the studies. Accuracy (n = 43) and sensitivity (n = 35) were the most common metrics for evaluating CDSS. Conclusion: CDSS for COVID-19 diagnosis have been developed mainly through machine learning (ML) methods. The greater use of these techniques can be due to their availability of public data sets about chest imaging. Although these studies indicate high accuracy for CDSS based on ML, their novelty and data set biases raise questions about replacing these systems as clinician assistants in decision-making. Further studies are needed to improve and compare the robustness and reliability of nonknowledge-based and knowledge-based CDSS in COVID-19 diagnosis.

Determining the readiness of patients with renal failure to use health information technology.

INTRODUCTION: Using information technology (IT) for purposes such as patient education and disease prevention and management is effective when patients are ready to use it. The objective of this study was to determine the readiness of patients with renal failure to use health IT. METHODS: This study was performed on all dialysis patients in South Khorasan province (n = 263) using a 28-item questionnaire. The questionnaire consisted of (1) demographic information of participants and (2) questions concerning eight main factors including the need for information, desire to receive information, ability to use computers and the Internet, computers and the Internet anxiety, communication with physicians, using mobile phones and concerns about security and confidentiality of information. Descriptive statistics and Mann-Whitney and Kruskal-Wallis statistical tests were used to analyze the data. RESULTS: About 15% of the participants stated that they do not want to receive information from the Internet. Anxiety and concern about Internet security and confidentiality were higher in women, married people, people over 60, villagers, and illiterate people (p < 0.05). Married people and people over 60 years had a higher desire to get information (p < 0.05). The rate of computer anxiety and Internet privacy concern was higher than average (p < 0.001). Most patients (34.2%) could only send text messages using mobile phones. CONCLUSION: Despite the need of most patients to online health information, they do not use this information due to a lack of skills and experience to use IT. Therefore, the ability of users should be considered when developing IT-based interventions. Due to patients' concerns about Internet privacy, it is required to teach patients how to protect their privacy while using the Internet.

Methods of Reimbursement for Telemedicine Services: A Scoping Review.

Background: With the advent of coronavirus-2019 (COVID-19), telemedicine services have played an essential role in reducing the transmission of this virus between patients and health care providers. Nevertheless, financial and reimbursement barriers are the biggest challenge in adopting these technologies. It seems necessary to determine the successful reimbursement methods in different countries. The purpose of this study was to identify methods of reimbursing telemedicine services. Methods: A search without time limitation was conducted on the PubMed, Web of Science, and Scopus databases in December 2020 and updated in January 2022. Articles were identified using predefined inclusion and exclusion criteria. Two researchers independently evaluated the titles, abstracts, and full text of the articles. Results: Out of 4946 identified articles, 28 articles were included. In these studies, the most used insurances were Medicare (n = 17), and Medicaid (n = 15). The majority of services included telepsychiatry (n = 7), telehealth (n = 7), and telemedicine (n = 7). There was no difference between the reimbursements in telemedicine services and face-to-face visits in 18 studies. Conclusion: Various government, state, and private insurance reimbursed telemedicine services. In most studies, there was no difference between reimbursing telemedicine services and in-person visits. Differences in the type and number of reimbursements may be due to the year of publication of the articles, changes in covered service policies, and state laws. Because of the COVID-19 pandemic, it is crucial to develop and update the guidelines and regulations for telemedicine reimbursement. Future studies can examine the telemedicine reimbursement methods in developed and developing countries before and after the COVID-19 pandemic.

Impact of Mobile Phone-Based Interventions on Methamphetamine Use and High-risk Sexual Behaviors in Men Who Have Sex with Men (MSM): A Systematic Review.

BACKGROUND: Today, increased use of methamphetamine in homosexual men is associated with high-risk sexual behaviors and (HIV) epidemic. Mobile phone-based interventions are an accessible and rapid method to provide healthcare services to this population. This study aimed to systematically review the effects of mobile phone-based interventions on methamphetamine use and high-risk sexual behaviors in homosexual men. METHODS: This systematic review was conducted by two researchers via searching in PubMed, Google Scholar, Web of Science, Scopus, and PsycINFO databases to retrieve the published articles regarding the effects of mobile phone-based interventions on the control of methamphetamine use and high-risk sexual behaviors. FINDINGS: Among 250 unique articles that were retrieved, only five cases met all the inclusion criteria of the study. Accordingly, some of the applied interventions included text messaging (n = 4) and mobile apps (n = 1). In this regard, the use of text messaging significantly decreased the rates of methamphetamine use, condomless anal intercourse (CAI), and HIV transmission among homosexual men. CONCLUSION: According to the results, short-term interventions based on text messaging could decrease the rates of methamphetamine use and the high-risk sexual behaviors associated with HIV infection in homosexual men. Despite the positive impact of these interventions, long-term follow-ups are required for individuals using methamphetamine in different communities.

Investigating Pharmacists' Views on Telepharmacy: Prioritizing Key Relationships, Barriers, and Benefits.

Background: Telepharmacy can help deliver pharmaceutical advice from an expert pharmacist to another party, such as a physician, inexperienced pharmacist, or pharmacy technician. In this study, we consider term "2-person discussions" as teleconsultation between expert pharmacists to each of the aforementioned persons. Objectives: This study has 2 aims: first to prioritize 2-person discussions between the parties involved in telepharmacy services when we have limited budget and time and would like to implement the best efficient telepharmacy system. Second to examine the barriers and benefits of implementing a telepharmacy. Methods: The research population included 40 pharmacists working in Kerman pharmacies (Iran). Their viewpoints were evaluated using a valid and reliable researcher-made questionnaire. The first part of the questionnaire focused on professional-demographic information, while the second part addressed the most important 2-person discussions and also asked about barriers to and benefits of implementing telepharmacy. Results: The findings indicate that the following 2-person discussions are priority for implementation: physician-pharmacist, pharmacist-hospital ward, and pharmacist-pharmacist. Payment and reimbursement issues and lack of access to information technology infrastructure were among the most important barriers. Efficient training about medicine usage, drug-drug interactions, and adverse effects was the most important benefit of telepharmacy. Conclusion: In this study, pharmacists' first priority regarding who to involve in a 2-person telepharmacy consultation was to establish a long-distance connection between physicians and pharmacists. This finding indicates that the pharmacists were more interested in providing teleconsultation services to physicians and other pharmacists rather than communicating with pharmaceutical technicians.

LabSafety, the Pharmaceutical Laboratory Android Application, for Improving the Knowledge of Pharmacy Students.

Currently, traditional paper methods may not effectively be used in education due to lack of access, outdated content, and poor graphics. Education through mobile-based applications is one of the alternative solutions. The objective of this study was to develop and evaluate LabSafety educational application and its effect on promoting the knowledge of pharmacy students. In this interventional study, the LabSafety application was first developed and evaluated for educating students about the safety measures in laboratories. Then, all pharmacy students from Kerman University of Medical Sciences (n = 316) were selected and randomly enrolled into one of three groups using simple random sampling: control (n = 106), traditional (n = 105), and application (n = 105) groups. To assess students' knowledge before and after the intervention, two valid and reliable (Cronbach's Alpha = 0.94 and 0.93, respectively) questionnaires were used. The results of the study showed no significant differences among the mean scores of the participants' knowledge before intervention (p = 0.82). After the intervention, the mean scores of the application group were 5.52 higher than the scores of the traditional group and 7.3 higher than the scores of the control group (p < 0.0001). Age had no significant effect on the posttest scores of the participants (p = 0.52). As a result, the use of this educational application can effectively increase the knowledge of all age groups of pharmacy students regarding safety measures in pharmaceutical laboratories. The mobile-based applications with online and offline access, interactive features, and user-friendly interfaces are more engaging and they can be used complementary to traditional training methods. © 2019 International Union of Biochemistry and Molecular Biology, 48(1):44-53, 2020.

Challenges of Implementing Picture Archiving and Communication System in Multiple Hospitals: Perspectives of Involved Staff and Users.

Today, despite the advantages of the PACS system, its implementation in some healthcare organizations faces many challenges. One of the important factors in the successful implementation of a PACS system is identifying and prioritizing the challenges from the perspectives of involved staff and user of this system. Therefore, the aim of this study was to determine and compare the challenges of implementing PACS from perspectives these users in educational hospitals. This study was conducted on all IT and medical equipment staff, and radiology residents (n = 140) in Kerman University of Medical Sciences (KUMS) and Shiraz University of Medical Sciences (SUMS) in 2016. The data were collected through two researcher-made questionnaires. Their validity was approved by radiologists, IT staff, and medical informatics specialists and their reliability through calculation of Cronbach's Alpha (0.969 and 0.795). We used Multivariate Analysis of Variance (MANOVA) to compare the scores given by three groups of participants in the challenges and Univariate Analysis of Variance (ANOVA) to compare the scores in two universities. The participants believed that technical challenges were more important than other challenges (x̄=3.74, SD = 0.7). IT experts (x̄=3.87, SD = 1) and radiology residents (x̄=3.95, SD = 0.9) gave the higher scores to the "shortage of high quality monitors" factor and medical equipment experts (x̄=4.26, SD = 0.87) to the "low speed of communication networks" factor among all technical challenges. The mean scores given to technical (x̄=76.1, SD = 13.5) and managerial (x̄=16, SD = 5.9) challenges in SUMS were more than the scores of the same challenges in KUMS (x̄=69.9, SD = 15.7) and (x̄=11.9, SD = 6.4) (p < 0.05). The technical challenges are the most common challenges to PACS implementation, and different universities experience different levels of technical challenges. Eliminating implementation challenges can reduce the risk of failure in the utilization process. Based on the results of this study, providing necessary infrastructures such as appropriate monitors and upgraded IT equipment can prevent many of the PACS implementation challenges.

Evaluating the agreement of users with usability problems identified by heuristic evaluation.

OBJECTIVE: Heuristic evaluation (HE) is an inspection method that can be used for identifying usability problems of health information systems. There is insufficient evidence to what extent these problems are experienced by users in their working environment. The objective of this study was to investigate the agreement of real end users of a health information system with the problems identified by HE. METHODS: First, the emergency information system of educational hospitals in Kerman, Iran was evaluated by a heuristic evaluation. Then, a valid and reliable (Cronbach's alpha = 0.95) electronic questionnaire was designed based on the results of the first phase. RESULTS: Among 127 identified problems, the highest number of problems was related to the "consistency and standards" heuristic (18.9%). The user agreement coefficient with heuristic results was 0.5. The highest agreement of the participants was on the problems related to the "help user recognize, diagnose and recover from errors" heuristic (78%). There was a significant relationship between participants age and work experience with a computer (p < 0.05). CONCLUSION: The agreement rate of real end users with the results of HE was at a medium level. Therefore, in some areas, the perception of evaluators in using this method is not consistent with the users experience with a system. This can result in identifying minor issues and ignoring important system-critical usability issues. The HE is appropriate for identifying specific problems, such as problems related to identifying and correcting errors, but in some areas, such as consistency and standards in the design of a system, it identifies minor or ineffective problems.