Exploring ICOPE's Impact on Delaying Elderly Disability Management.

The purpose of this study was to explore the initial benefits of introducing the ICOPE (Integrated care for older people) information assessment system for the management of hospitalized elderly patients in a teaching hospital in Eastern Taiwan. The ICOPE information assessment system was set up for case screening and abnormal referral through clinical ICOPE, followed by follow-up and case management. The results showed a total of 3424 screened cases, an average of 311 ICOPE screenings per month, an average of 48 abnormal screenings per month (15%), a referral rate of 79%, a rescreening rate of 91%, and a case management completion rate of 71%. Conclusion: Introducing the ICOPE information evaluation system can quickly screen for potential abnormal disability cases in hospitalized elderly patients, timely referral case management, provide appropriate intervention measures, and improve the quality of life after returning home in old age.

Dietary and herbal supplement consumer health information for pain: A cross-sectional survey and quality assessment of online content.

Background: Patients are increasingly utilizing the internet to learn about dietary and herbal supplements (DHSs) for various diseases/conditions, including pain management. Online health information has been found to be inconsistent and of poor quality in prior studies, which may have detrimental effects on patient health. This study assessed the quality of online DHSs consumer health information for pain. Methods: Six search items related to DHSs and pain were used to generate the first 20 websites on Google across four English-speaking countries. The identified 480 webpages produced 68 eligible websites, which were then evaluated using the DISCERN tool. The mean scores and standard deviations (SD) of the reviewers' ratings on each of the 15 DISCERN instrument items as well as the overall total score were calculated. Results: The mean summed score for the 68 eligible websites was 46.6 (SD = 10.1), and the mean overall rating was 3.3 (SD = 0.8). Websites lacked information regarding areas of uncertainty, the effects of no treatment being used, and how treatments affect the overall quality of life. These shortcomings were especially apparent across commercial websites, which frequently displayed bias, failed to report the risks of DHS products, and lacked support for shared decision-making regarding the use of DHSs. Conclusion: Variability exists in the quality of online consumer health information regarding DHS use for pain. Healthcare providers should be aware of and provide guidance to patients regarding the identification of reliable online resources so that they can make informed decisions about DHS use for pain management.

Content and Face Validity of the Evaluation Tool of Health Information for Consumers (ETHIC): Getting Health Information Accessible to Patients and Citizens.

BACKGROUND: Health information concerns both individuals' engagement and the way services and professionals provide information to facilitate consumers' health decision making. Citizens' and patients' participation in the management of their own health is related to the availability of tools making health information accessible, thus promoting empowerment and making care more inclusive and fairer. A novel instrument was developed (Evaluation Tool of Health Information for Consumers-ETHIC) for assessing the formal quality of health information materials written in Italian language. This study reports ETHIC's content and face validity. METHODS: A convenience sample of 11 experts and 5 potential users was involved. The former were requested to evaluate relevance and exhaustiveness, the latter both readability and understandability of ETHIC. The Content Validity Index (CVI) was calculated for ETHIC's sections and items; experts and potential users' feedback were analyzed by the authors. RESULTS: All sections and most items were evaluated as relevant. A new item was introduced. Potential users provided the researchers with comments that partly confirmed ETHIC's clarity and understandability. CONCLUSIONS: Our findings strongly support the relevance of ETHIC's sections and items. An updated version of the instrument matching exhaustivity, readability, and understandability criteria was obtained, which will be assessed for further steps of the validation process.

The quality of health information provided on web sites selling cannabis to consumers in Canada is poor.

BACKGROUND: Cannabis is used by millions of people for both medical and recreational purposes, and this use is even greater in jurisdictions where it is legalized, such as Canada. Online cannabis vendors have gained popularity for purchasing cannabis due to easy access and convenience to consumers. The objective of this study was to evaluate the quality of health information provided by web sites of cannabis vendors selling products to Canadian consumers and to further identify trends in the information provided. METHODS: Six different searches were conducted on Google.ca, and the first 40 webpages of each search were screened for eligibility. A total of 33 unique web sites of cannabis vendors selling products to Canadian consumers were identified and included. The DISCERN instrument, which consists of 16 questions divided into three sections, was used to evaluate the quality of cannabis-related health information on these web sites. RESULTS: Across the 33 web sites, the average of the summed DISCERN scores was 36.83 (SD = 9.73) out of 75, and the mean score for the overall quality of the publication (DISCERN question 16) was 2.41 (SD = 0.71) out of 5. Many of these web sites failed to discuss uncertainties in research evidence on cannabis, the impact of cannabis use on quality of life, alternatives to cannabis use, risks associated with cannabis use, and lacked references to support claims on effects and benefits of use. CONCLUSION: Our findings indicate that the quality of cannabis-related health information provided by online vendors is poor. Healthcare providers should be aware that patients may use these web sites as primary sources of information and appropriately caution patients while directing them to high-quality sources. Future research should serve to replicate this study in other jurisdictions and assess the accuracy of information provided by online cannabis vendors, as this was outside the scope of the DISCERN instrument.

Lessons learned from using whiteboard videos and YouTube for deprescribing guidelines knowledge mobilization.

OBJECTIVES: Deprescribing is the planned and supervised process of dose reduction or stopping medication. Few clinical guidelines exist to help health care professionals in making decisions about deprescribing. The Bruyère Deprescribing Guidelines Team developed a series of evidence-based medication-class specific deprescribing guidelines and, to extend reach and uptake, disseminated them as whiteboard videos published on YouTube. This paper reports on the creation, sharing and evaluation of videos on proton pump inhibitor (PPI), antihyperglycemic (AHG), antipsychotic (AP) and benzodiazepine receptor agonist (BZRA) deprescribing guidelines. METHODS: Whiteboard videos depict an animator drawing on a whiteboard, while the narrator reads the script. In each video, the deprescribing algorithm is applied to mock patient cases. The videos were shared on YouTube and promoted via Twitter and other web-based tools. Evaluation methods included YouTube analytics and the validated Information Assessment Method (IAM) questionnaire. KEY FINDINGS: The four videos have a combined total of 26 387 views over the approximately 50 months since publishing, with viewers watching 34-40% of the videos' runtimes on average. The PPI and AHG deprescribing videos were viewed 4318 times in 97 countries during the first year. IAM respondents perceived the PPI, AHG and AP video content to be relevant, useful to learning and applicable to patient care. CONCLUSIONS: Using whiteboard videos on YouTube to explain deprescribing guidelines was a successful approach to knowledge mobilization. The evaluation approach is innovative as it combines typical success factors for online learning videos (e.g. views, estimated minutes watched) with responses to a validated information assessment tool.

Information seeking criteria: artificial intelligence, economics, psychology, and neuroscience.

There has been an enormous amount of interest in how the brain seeks information. The study of this issue is a rapidly growing field in neuroscience. Information seeking is to make informative choices among multiple alternatives. A central issue in information seeking is how the value of information is assessed in order to choose informative alternatives. This issue has been studied in psychology, economics, and artificial intelligence. The present review is focused on information assessment and summarizes the psychological and computational criteria with which humans and computers assess information. Based on the summary, neurophysiological findings are discussed. In addition, a computational view of the relationships between these criteria is presented.

Quality of complementary and alternative medicine information for type 2 diabetes: a cross-sectional survey and quality assessment of websites.

BACKGROUND: The global prevalence of diabetes mellitus is projected to reach approximately 700 million by the year 2045, with roughly 90-95% of all diabetes cases being type 2 in nature. Patients with type 2 diabetes mellitus (T2DM) frequently seek information about complementary and alternative medicine (CAM) online. This study assessed the quality of publicly accessible websites providing consumer health information at the intersection of T2DM and CAM. METHODS: An online search engine (Google) was searched to identify pertinent websites containing information specific to CAM for T2DM patients, and the relevant websites were then screened with an eligibility criteria. Consumer health information found on eligible websites were then assessed for quality using the DISCERN instrument, a 16-item standardized scoring system. RESULTS: Across the 480 webpages identified, 94 unique webpages remained following deduplication, and 37 eligible webpages belonged to and were collapsed into 30 unique websites that were each assessed using the DISCERN instrument. The mean overall quality score (question 16) across all 30 assessed websites was 3.55 (SD = 0.86), and the mean summed DISCERN score was 52.40 (SD = 12.11). Eighty percent of websites presented a wide range of CAM treatment options with the associated benefits/risks of each treatment, but in 56.7% of the websites, the sources used to collect information were unreliable. CONCLUSION: This study identified, assessed, and presents findings on the quality of online CAM information for T2DM. Although there were several high scoring websites, there was variability across most of the individual DISCERN items in the assessed websites. This study highlights the importance of awareness among healthcare providers regarding the reliability of online information about CAM treatment and management options for T2DM. Healthcare providers should be aware of patients' information seeking behaviour, guide them in navigating through the content they encounter online, and provide them with resources containing trustworthy and reliable information.

Dietary and herbal supplements for weight loss: assessing the quality of patient information online.

BACKGROUND: Given the high prevalence of dietary and herbal supplement (DHS) use in tandem with the growing ease of internet access, patients commonly search online for consumer health information about these products. One common reason for DHSs use includes weight loss. Healthcare providers need to be aware of the quality of online information about DHSs for weight loss so they can adequately counsel their patients and provide them with guidance surrounding the identification of high-quality information resources. This study aimed to assess the quality of online DHSs consumer health information for weight loss that a "typical" patient might access online. METHODS: Six search terms were used to generate the first 20 websites on the Google search engine in four countries: Australia, Canada, the United Kingdom, and the United States (n = 480 websites). After applying exclusion criteria, eligible websites were quality assessed using the DISCERN instrument. This tool is comprised of 16 questions, each evaluated on a 5-point scale. The averages and standard deviations for each DISCERN instrument item, in addition to overall summed scores between 15 and 75 were calculated. RESULTS: Across 87 eligible websites, the mean summed score was 44.80 (SD = 11.53), while the mean overall DISCERN score of each website was 2.72 (SD = 0.99). In general, websites detailed and achieved their specified aims and described treatment benefits. However, most websites failed to describe the impact of treatment on overall quality of life and the impact of a no treatment option. The highest-scoring websites were largely government or health portal websites, while the lowest-scoring websites were largely commercial in nature. CONCLUSION: High variability in DISCERN instrument scores was found across all websites assessed. Healthcare providers should be aware of the fact that their patients may be accessing misinformation online surrounding the use of DHSs for weight loss. Therefore, it is important for healthcare providers to ensure that they are providing their patients with guidance on how to identify high-quality resources online, in order that safe, effective, and evidence-based decisions are made surrounding the use of DHSs for weight loss.

The quality of online consumer health information at the intersection of complementary and alternative medicine and arthritis.

BACKGROUND: Complementary and alternative medicine (CAM) use is prevalent among patients living with arthritis. Such patients often seek information online, for the purpose of gaining a second opinion to their healthcare provider or even self-medication. Little is known about the quality of web-based consumer health information at the intersection of CAM and arthritis; thus, investigating the quality of websites containing this information was the purpose of this study. METHODS: Four unique search terms were searched on Google across four English-speaking countries. We assessed the first 20 results of each search, including them if they contained CAM consumer health information for the treatment and/or management of arthritis. Eligible websites were assessed in duplicate using the DISCERN instrument, which consists of 16-items designed to assess quality. RESULTS: Of total of 320 webpages, 239 were duplicates, and a total of 38 unique websites were deemed eligible and assessed using the DISCERN instrument. The mean summed  DISCERN scores across all websites was 55.53 (SD = 9.37). The mean score of the overall quality of each website was 3.71 (SD = 0.63), thus the majority of websites are ranked as slightly above 'fair' quality. CONCLUSION: Eligible websites generally received scores better than 'moderate' in terms of overall quality. Several shortcomings included a lack of transparency surrounding references used and underreporting of risks associated with treatment options. These results suggest that health providers should be vigilant of the variable quality of information their patients may be accessing online and educate them on how to identify high quality resources.

The quality of online consumer health information at the intersection of complementary and alternative medicine and arthritis

Abstract Background: Complementary and alternative medicine (CAM) use is prevalent among patients living with arthritis. Such patients often seek information online, for the purpose of gaining a second opinion to their healthcare provider or even self-medication. Little is known about the quality of web-based consumer health information at the intersection of CAM and arthritis; thus, investigating the quality of websites containing this information was the purpose of this study. Methods: Four unique search terms were searched on Google across four English-speaking countries. We assessed the first 20 results of each search, including them if they contained CAM consumer health information for the treatment and/or management of arthritis. Eligible websites were assessed in duplicate using the DISCERN instrument, which consists of 16-items designed to assess quality. Results: Of total of 320 webpages, 239 were duplicates, and a total of 38 unique websites were deemed eligible and assessed using the DISCERN instrument. The mean summed DISCERN scores across all websites was 55.53 (SD = 9.37). The mean score of the overall quality of each website was 3.71 (SD = 0.63), thus the majority of websites are ranked as slightly above 'fair' quality. Conclusion: Eligible websites generally received scores better than 'moderate' in terms of overall quality. Several shortcomings included a lack of transparency surrounding references used and underreporting of risks associated with treatment options. These results suggest that health providers should be vigilant of the variable quality of information their patients may be accessing online and educate them on how to identify high quality resources.(AU)

Ecological content validation of the Information Assessment Method for parents (IAM-parent): A mixed methods study.

This mixed methods study content validated the Information Assessment Method for parents (IAM-parent) that allows users to systematically rate and comment on online parenting information. Quantitative data and results: 22,407 IAM ratings were collected; of the initial 32 items, descriptive statistics showed that 10 had low relevance. Qualitative data and results: IAM-based comments were collected, and 20 IAM users were interviewed (maximum variation sample); the qualitative data analysis assessed the representativeness of IAM items, and identified items with problematic wording. Researchers, the program director, and Web editors integrated quantitative and qualitative results, which led to a shorter and clearer IAM-parent.

The role of tentative decisions and health concepts in assessing information about mammography screening.

Breast cancer awareness campaigns and screening programs are important public health issues. In order to deepen women's knowledge about mammography screening, a balanced presentation of arguments is considered to be relevant. Yet, little is known about how women process this information and assess pro and contra arguments, which, in turn, can be embedded in different health paradigms. The aim of this experimental study was to determine the impact of both women's pre-formed, tentative decisions about whether to participate in mammography screening and of their individual health concepts on their assessment of different arguments about mammography screening. The results showed that women who would tend at the outset to participate in mammography screening rated information about advantages as more relevant than information about disadvantages--in contrast to women who did not intend to participate. In addition, the greater the fit was between women's individual health concepts and the health concept presented in the arguments, the more they considered the information presented to be relevant. We conclude that presenting balanced information about mammography screening does not guarantee balanced processing of that information. Health professionals need to be aware of people's prior beliefs and of the health paradigm in which information is embedded.

[Assessment of quality of pre- and postoperative information documents about carpal tunnel syndrome]. / Évaluation de la qualité de l'information en fonction du support utilisé avant et après chirurgie du canal carpien.

Before surgery for carpal tunnel syndrome, oral patient information is partially understood and accepted. The objective of this study was to perform a documentation for patients, as recommended by the High Authority in Healthcare (HAS), then to compare the effectiveness of oral information. Our series included 37 patients who received the same information: preoperative shower, pathophysiology, and postoperative instructions. The first 18 (group 1) received only oral information. The following 19 (group 2) received oral, written and visual information. The information in Group 2 followed the methodology of McClune: promoter (Department of Hand Surgery), organizing committee (two teachers from the School of Decorative Arts, two teachers of the School of Medicine), group work (five art students, five medical students), panel of experts (three surgeons, two occupational therapists, one physiotherapist). Four documents were developed: a booklet, a diagram, an animation, a poster. Satisfaction was higher in group 2. Understanding and memorization were better in group 2. Fifty-six percent of patients in group 1 would have liked a paper, 12.5% videos, none went on the Internet. Twelve and a half percent of the patients in group 2 went on the Internet, 18.8% would have liked videos. Our results show that in terms of carpal tunnel syndrome, the written and visual information materials for patients significantly improve the efficacy of oral information. These documents may be extended to other pathologies in Hand Surgery.

Number needed to benefit from information (NNBI): proposal from a mixed methods research study with practicing family physicians.

PURPOSE: We wanted to describe family physicians' use of information from an electronic knowledge resource for answering clinical questions, and their perception of subsequent patient health outcomes; and to estimate the number needed to benefit from information (NNBI), defined as the number of patients for whom clinical information was retrieved for 1 to benefit. METHODS: We undertook a mixed methods research study, combining quantitative longitudinal and qualitative research studies. Participants were 41 family physicians from primary care clinics across Canada. Physicians were given access to 1 electronic knowledge resource on handheld computer in 2008-2009. For the outcome assessment, participants rated their searches using a validated method. Rated searches were examined during interviews guided by log reports that included ratings. Cases were defined as clearly described searches where clinical information was used for a specific patient. For each case, interviewees described information-related patient health outcomes. For the mixed methods data analysis, quantitative and qualitative data were merged into clinical vignettes (each vignette describing a case). We then estimated the NNBI. RESULTS: In 715 of 1,193 searches for information conducted during an average of 86 days, the search objective was directly linked to a patient. Of those searches, 188 were considered to be cases. In 53 cases, participants associated the use of information with at least 1 patient health benefit. This finding suggested an NNBI of 14 (715/53). CONCLUSION: The NNBI may be used in further experimental research to compare electronic knowledge resources. A low NNBI can encourage clinicians to search for information more frequently. If all searches had benefits, the NNBI would be 1. In addition to patient benefits, learning and knowledge reinforcement outcomes are frequently reported.

An online knowledge resource and questionnaires as a continuing pharmacy education tool to document reflective learning.

OBJECTIVE: To assess the use of an electronic knowledge resource to document continuing education activities and reveal educational needs of practicing pharmacists. METHODS: Over a 38-week period, 67 e-mails were sent to 6,500 Canadian Pharmacists Association (CPhA) members. Each e-mail contained a link to an e-Therapeutics+ Highlight, a factual excerpt of selected content from an online drug and therapeutic knowledge resource. Participants were then prompted to complete a pop-up questionnaire. RESULTS: Members completed 4,140 questionnaires. Participants attributed the information they learned in the Highlights to practice improvements (50.4%), learning (57.0%), and motivation to learn more (57.4%). CONCLUSIONS: Reading Highlight excerpts and completing Web-based questionnaires is an effective method of continuing education that could be easily documented and tracked, making it an effective tool for use with e-portfolios.

Avaliação dos sistemas de informação em saúde no Brasil / Evaluation of Health Information Systems in Brazil

Conhecer o nível de saúde de uma população é importante para avaliar prioridades e estabelecerprogramas. Os indicadores facilitam a análise das informações, mas sua qualidade vai dependerda precisão dos sistemas de informação. Em 2000, OMS destacou cinco pontos críticos relativosaos sistemas de informação em saúde, que podem se tornar obstáculos para gestores. O trabalho objetiva mostrar as falhas nos principais sistemas de informação em saúde no Brasil, frentea esses tópicos. A incapacidade em oferecer informações necessárias aos gestores, a inexistênciade retroalimentação das informações entre níveis local, regional e nacional, dados incompletos,inadequados, não oportunos e, muitas vezes, não relacionados às ações prioritárias são comentados. Refere-se, ainda, à necessidade de serem adotados conceitos e definições internacionais,adequação na elaboração dos itens nos formulários de coleta e uso de linkage entre diferentesbancos de dados. Os próprios gestores de saúde reconhecem que uma das ferramentas maisimportantes para a vigilância em saúde é a informação, visto que ?informação-decisão-ação?sintetiza a dinâmica da vigilância epidemiológica. Em todos os Sistemas, vem ocorrendo melhorasignificativa, mas, há ainda muito a ser feito, no sentido de que as informações cumpram adequadamente o papel que lhes cabe, no contexto da saúde no Brasil.

Knowing the level of population health is necessary for the assessment of priorities and toestablish appropriate programs. Health indicators facilitate this evaluation, but their qualitydepends on the accuracy of the health information systems. In 2000, WHO highlighted fivecritical points related to health systems, which could represent obstacles for health management.This article aims to show failures in the main Brazilian health information systems according tothose five points. The inappropriate offer of needed data to the managers, the lack of datafeedback among local, regional and national levels, incomplete, inadequate, inopportune dataand information unrelated to priority actions are presented as the main problems. It is alsoobserved the need to respect standardized concepts and definitions, to adjust the elaborationof items in questionnaires and to link different data bases. Health managers recognize that oneof the most important tools for health monitoring is the information, since ?information-decisionaction? summarizes the dynamics of Epidemiological Surveillance. In all Brazilian health systemssome significant improvement is occurring, but much more has to be done for the informationto fulfill its rightful role in the context of the Brazilian health.