Digital Health Literacy and Its Association With Sociodemographic Characteristics, Health Resource Use, and Health Outcomes: Rapid Review.

BACKGROUND: Digital health literacy has emerged as a critical skill set to navigate the digital age. OBJECTIVE: This review sought to broadly summarize the literature on associations between digital health literacy and (1) sociodemographic characteristics, (2) health resource use, and (3) health outcomes in the general population, patient groups, or parent or caregiver groups. METHODS: A rapid review of literature published between January 2016 and May 2022 was conducted through a search of 4 web-based databases. Articles were included on the basis of the following keywords: "measured digital health literacy," "digital literacy," "ehealth literacy," "e-health literacy," "electronic health literacy," or "internet health literacy" in adult populations; participants were from countries where English was the primary language; studies had to be cross-sectional, longitudinal, prospective, or retrospective, and published in English. RESULTS: Thirty-six articles met the inclusion criteria. Evidence on the associations between digital health literacy and sociodemographic characteristics varied (27/36, 75% included studies), with higher education (16/21, 76.2% studies that examined the association) and younger age (12/21, 57.1% studies) tending to predict higher digital health literacy; however, other studies found no associations. No differences between genders were found across the majority of studies. Evidence across ethnic groups was too limited to draw conclusions; some studies showed that those from racial and ethnic minority groups had higher digital health literacy than White individuals, while other studies showed no associations. Higher digital health literacy was associated with digital health resource use in the majority of studies (20/36, 55.6%) that examined this relationship. In addition, higher digital health literacy was also associated with health outcomes across 3 areas (psychosocial outcomes; chronic disease and health management behaviors; and physical outcomes) across 17 included studies (17/36, 47.2%) that explored these relationships. However, not all studies on the relationship among digital health literacy and health resource use and health outcomes were in the expected direction. CONCLUSIONS: The review presents mixed results regarding the relationship between digital health literacy and sociodemographic characteristics, although studies broadly found that increased digital health literacy was positively associated with improved health outcomes and behaviors. Further investigations of digital health literacy on chronic disease outcomes are needed, particularly across diverse groups. Empowering individuals with the skills to critically access and appraise reliable health information on digital platforms and devices is critical, given emerging evidence that suggests that those with low digital health literacy seek health information from unreliable sources. Identifying cost-effective strategies to rapidly assess and enhance digital health literacy capacities across community settings thus warrants continued investigation.

Web-Based System Navigation Database to Support Equitable Access to Assistive Technology: Usability Testing Study.

BACKGROUND: Assistive technology (AT) can contribute to how individuals participate and engage in everyday activities, such as communication and mobility, and facilitates access to the services they require. Navigating Canada's AT system has been described as fragmented and complex, presenting barriers for individuals who require AT, caregivers, and health service providers. AccessATCanada was developed as a centralized web-based resource to help support access to AT by providing information about the existing jurisdictional funding programs and services. OBJECTIVE: This study aimed to evaluate the usability of AccessATCanada by gathering feedback about its features, functionality, and areas of strength and opportunity from potential end users. METHODS: A usability testing study using a think-aloud approach and semistructured interviews was conducted to measure the effectiveness and efficiency of and user satisfaction with AccessATCanada and to identify issues with the interface during end-user interaction. A qualitative thematic analysis was used to generate insights into and core themes about user experiences. User feedback was used to inform subsequent updates of the database with the goal of enhancing website friendliness and functionality before its official launch. RESULTS: A total of 10 participants (6 consumers, 1 caregiver, and 3 providers) participated in the usability testing study. The usability performance and scores tended to improve between the 2 testing cycles. Most participants were able to successfully complete all the tasks independently. The efficiency scores tended to improve as the users continued to engage with the interface. The website received an overall System Usability Score of 62.22, which was ranked as "OK/fair to good." The users provided an overall positive evaluation of the beta version of the web-based resource tested over 2 cycles and helped to identify areas for improvement. They commented on the functionality and added value of the website, discovery of new programs and resources, and design aesthetics. Most usability issues were reported as minor challenges related to presentation, functionality, and language, and feedback was adopted into later iterations of the website. CONCLUSIONS: This study provides reflections on the value of usability testing and elements that are key to the creation of user-centered resources, such as the inclusion of participants with various abilities and considerations regarding website design and accessibility in an increasingly web-based world. AccessATCanada is now part of a growing global response to expand the reach of AT programs and services, improve the equity of access to AT, and reduce the complexity of navigating AT systems.

Implementation of a Departmental Resident Web-Based Database.

RATIONALE AND OBJECTIVES: The Accreditation Council for Graduate Medical Education requires the gathering, monitoring, analysis, and reporting of a large number of resident performance parameters. To provide faster and more efficient documentation and tracking, we developed an online database. MATERIAL AND METHODS: We used a commercial, customizable and affordable web-based relational database software to develop a multiplatform, flexible database that can track a myriad of resident data and is easy for residents, faculty, and administrative personnel to enter and retrieve specific data. The database can quickly build report pages/pivot tables according to user specifications/needs. RESULTS: Since the implementation in January 2015-April 2020, over 34,355 data entries have been made. Around 82% of our current residents agree or strongly agree that the database is a useful addition to our program, with 53% of resident respondents agreeing or strongly agreeing that the database is intuitive, easy to navigate, and allows for quick data entry. A total of 61% of the faculty respondents agreed or strongly agreed that the database is a useful addition to the residency program. Pre Clinical Competency Committee (CCC) meeting preparation time by the Program Coordinator has been reduced by about 90%, and by CCC faculty by at least 50%. Annual Accreditation Data System (ADS) web reporting has become faster and more streamlined. CONCLUSION: The database has markedly facilitated and improved efficiency of Milestones and ADS reporting as well as preparation and review of this data at CCC and Program Evaluation Committee meetings. Residents can monitor their own performance throughout residency. The database structure can be exported to other institutions.

Improvement in MR quality control workflow and outcomes with a web-based database.

PURPOSE: To describe a custom-built, web-based MR Quality Control (QC) database, and to assess its impact on the QC workflow and outcomes in a large U.S. academic medical center. METHODS: The MR QC database was built with Microsoft Access 2010 and published on a Microsoft Sharepoint website owned and maintained by the authors' institution. Authorized users can access the database remotely with mainstream web browsers on any institutional computers. QC technologists were granted access to add, review, and print daily and weekly QC records. Qualified medical physicists (QMPs) were granted additional access to edit, review, and approve existing QC records and to change tolerance limits. A macro was utilized to conduct an automatic weekly review of QC status and to email the results to a QMP. This web-based QC database was implemented on 17 clinical MRIs at the authors' institution. Weekly ACR QC findings within one year before and after implementation were compared. RESULTS: We analyzed 158 QC issues detected by the web-based database and 127 QC issues identified in conventional paper records before we implemented the database. The web-based database significantly reduced the number of QC issues due to technologist error (before/after: 59/24 cases, P < 0.0001) but did not affect the number of QC issues related to scanner performance (before/after: 49/46 cases, P = 1). Further analysis revealed that the web-based database significantly reduced the average time for the QMPs to identify a QC issue (before/after: 177 ± 110/2 ± 2 days, P < 0.0001) and time to correction (before/after: 81 ± 102/7 ± 8 days, P < 0.0001). The correction rate also significantly increased (before/after: 22%/99%, P < 0.0001). CONCLUSION: The web-based QC database provides a positive impact on our MR QC workflow and outcomes. It simplifies QC workflow, enables early detection of quality issues, and facilitates quick resolution of problems that may affect the quality of clinical MRI studies.

Initial verification of data from a clinical database of gastroenterological surgery in Japan.

PURPOSES: To evaluate the reliability of data collected from the gastroenterological section of the National Clinical Database of Japan (NCD), which began registrations in 2011 with ten surgical subspecialty societies. METHODS: During 2014 and 2015, 1,136,700 cases involving 115 procedures at 4374 hospitals were registered in the gastroenterological surgery section of the NCD. After a test audit using the 2014 data, 17 hospitals were selected for the first audit and data verification for 2015. The data accuracy of patient demographics, surgical outcomes, and processes was assessed using 45 items from the cases registered, in comparison with the medical records. RESULTS: In the first audit of the 2015 data, case registration accuracy verification involved 338 patients (99.4% of the extracted cases). The data accuracy with the maximum postoperative variables was > 95%. Accuracy of the mortality and status 30 days after the surgery was high (> 99%) with a sensitivity of 1.00 and a specificity of 1.00. Among the six complications studied, the recorded cases had high specificity but lower sensitivity (0.70-0.89). CONCLUSIONS: We verified the data from the gastroenterological section of the NCD and found high accuracy of data entry.

National Clinical Database feedback implementation for quality improvement of cancer treatment in Japan: from good to great through transparency.

The National Clinical Database (NCD) of Japan was established in April, 2010 with ten surgical subspecialty societies on the platform of the Japan Surgical Society. Registrations began in 2011 and over 4,000,000 cases from more than 4100 facilities were registered over a 3-year period. The gastroenterological section of the NCD collaborates with the American College of Surgeons' National Surgical Quality Improvement Program, which shares a similar goal of developing a standardized surgical database for surgical quality improvement, with similar variables for risk adjustment. Risk models of mortality for eight procedures; namely, esophagectomy, partial/total gastrectomy, right hemicolectomy, low anterior resection, hepatectomy, pancreaticoduodenectomy, and surgery for acute diffuse peritonitis, have been established, and feedback reports to participants will be implemented. The outcome measures of this study were 30-day mortality and operative mortality. In this review, we examine the eight risk models, compare the procedural outcomes, outline the feedback reporting, and discuss the future evolution of the NCD.

Effects of body mass index (BMI) on surgical outcomes: a nationwide survey using a Japanese web-based database.

PURPOSE: To define the effects of body mass index (BMI) on operative outcomes for both gastroenterological and cardiovascular surgery, using the National Clinical Database (NCD) of the Japanese nationwide web-based database. METHODS: The subjects of this study were 288,418 patients who underwent typical surgical procedures between January 2011 and December 2012. There were eight gastroenterological procedures, including esophagectomy, distal gastrectomy, total gastrectomy, right hemicolectomy, low anterior resection, hepatectomy of >1 segment excluding the lateral segment, pancreaticoduodenectomy, and surgery for acute diffuse peritonitis (n = 232,199); and five cardiovascular procedures, including aortic valve replacement, total arch replacement (TAR), descending thoracic aorta replacement (descending TAR), and on- or off-pump coronary artery bypass grafting (n = 56,219). The relationships of BMI with operation time and operative mortality for each procedure were investigated, using the NCD. RESULTS: Operation times were longer for patients with a higher BMI. When a BMI cut-off of 30 was used, the operation time for obese patients was significantly longer than that for non-obese patients, for all procedures except esophagectomy (P < 0.01). The mortality rate based on BMI revealed a U-shaped distribution, with both underweight and obese patients having high mortality rates for almost all procedures. CONCLUSIONS: This Japanese nationwide study provides solid evidence to reinforce that both obesity and excessively low weight are factors that impact operative outcomes significantly.

RKN Lethal DB: A database for the identification of Root Knot Nematode (Meloidogyne spp.) candidate lethal genes.

UNLABELLED: Root Knot nematode (RKN; Meloidogyne spp.) is one of the most devastating parasites that infect the roots of hundreds of plant species. RKN cannot live independently from their hosts and are the biggest contributors to the loss of the world's primary foods. RNAi gene silencing studies have demonstrated that there are fewer galls and galls are smaller when RNAi constructs targeted to silence certain RKN genes are expressed in plant roots. We conducted a comparative genomics analysis, comparing RKN genes of six species: Meloidogyne Arenaria, Meloidogyne Chitwoodi, Meloidogyne Hapla, Meloidogyne Incognita, Meloidogyne Javanica, and Meloidogyne Paranaensis to that of the free living nematode Caenorhabditis elegans, to identify candidate genes that will be lethal to RKN when silenced or mutated. Our analysis yielded a number of such candidate lethal genes in RKN, some of which have been tested and proven to be effective in soybean roots. A web based database was built to house and allow scientists to search the data. This database will be useful to scientists seeking to identify candidate genes as targets for gene silencing to confer resistance in plants to RKN. AVAILABILITY: The database can be accessed from http://bioinformatics.towson.edu/RKN/

Data collection and advanced statistical analysis in phytotoxic activity of aerial parts exudates of Salvia spp

In order to define the phytotoxic potential of Salvia species a database was developed for fast and efficient data collection in screening studies of the inhibitory activity of Salvia exudates on the germination of Papaver rhoeas L. and Avena sativa L.. The structure of the database is associated with the use of algorithms for calculating the usual germination indices reported in the literature, plus the newly defined indices (Weighted Average Damage, Differential Weighted Average Damage, Germination Weighted Average Velocity) and other variables usually recorded in experiments of phytotoxicity (LC50, LC90). Furthermore, other algorithms were designed to calculate the one-way ANOVA followed by Duncan's multiple range test to highlight automatically significant differences between the species. The database model was designed in order to be suitable also for the development of further analysis based on the artificial neural network approach, using Self-Organising Maps (SOM).

The effect of web-based histologic laboratories for general practical students / 中华医学教育探索杂志

ObjectiveTo assess the satisfaction of general practical students' perception with the two modes of histologic laboratory instruction,and obtain the advantages and disadvantages of each mode.MethodsWeb-based database was established and in the questionnaires were delivered to the general practical students ( n=193 ).Results75％ of students agreed that the case study component of the webbased laboratory instruction was arranged in order.82％ of students identified with the detailed word explanation attached to every image presented.ConclusionStudents support the progression of web-based histologic laboratory instruction,but it is difficult to replace traditional microscope with web-based database in histologic laboratory instruction.