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.

The preferred IT sources and tools of Iranian people for accessing health information.

INTRODUCTION: People need health information to maintain their health. Despite the variety of sources and tools for providing health information, there is little evidence about Iranian people's preferences in using these sources and tools. The objective of this study was to identify the preferred health information sources, tools, and methods for presenting health information in these tools. METHODS: This national survey was conducted among a sample of 4000 Iranian people between April and September 2021. The data was collected using a valid and reliable questionnaire (α = 0.86) consisting of four sections: participants' demographic information, current sources of obtaining health information, preferred information technology (IT) tools for accessing health information, and the method of presenting this information. Linear regression was used to investigate the relationship between demographic factors and other questions. RESULTS: The participants received health information mostly from the "Internet" (3.62), "family or friends" (3.43), "social networks" (3.41), "specific websites" (3.41), and "mobile apps" (3.27). "Social networks" (3.67), Internet "websites" (3.56), and "mobile apps" (3.50) were the most suitable tools for receiving health information. The participants preferred the presentation of health information in the form of "Images" (3.85), "educational videos" (3.69), and "texts" (3.53). Age, education, and marital status had a significant relationship with most of the preferred information sources, tools, and information presentation methods (p < 0.05). CONCLUSION: The results of this study showed that Iranian people are more active information seekers than passive ones compared to a decade ago. The preferred sources and tools identified in this research can be used by healthcare planners and policy-makers in Iran and other developing countries to design and develop IT interventions that meet people's needs. Improving access to the Internet, social networks, and mobile apps and providing health information via images, educational videos, and texts on these platforms enhance access to the information people need.

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.

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.