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Abstract: The importance and value of real-world data in healthcare cannot be overstated because it offers a valuable source of insights into patient experiences. Traditional patient-reported experience and outcomes measures (PREMs/PROMs) often fall short in addressing the complexities of these experiences due to subjectivity and their inability to precisely target the questions asked. In contrast, diary recordings offer a promising solution. They can provide a comprehensive picture of psychological well-being, encompassing both psychological and physiological symptoms. This study explores how using advanced digital technologies, i.e., automatic speech recognition and natural language processing, can efficiently capture patient insights in oncology settings. We introduce the MRAST framework, a simplified way to collect, structure, and understand patient data using questionnaires and diary recordings. The framework was validated in a prospective study with 81 colorectal and 85 breast cancer survivors, of whom 37 were male and 129 were female. Overall, the patients evaluated the solution as well made; they found it easy to use and integrate into their daily routine. The majority (75.3%) of the cancer survivors participating in the study were willing to engage in health monitoring activities using digital wearable devices daily for an extended period. Throughout the study, there was a noticeable increase in the number of participants who perceived the system as having excellent usability. Despite some negative feedback, 44.44% of patients still rated the app’s usability as above satisfactory (i.e., 7.9 on 1–10 scale) and the experience with diary recording as above satisfactory (i.e., 7.0 on 1–10 scale). Overall, these findings also underscore the significance of user testing and continuous improvement in enhancing the usability and user acceptance of solutions like the MRAST framework. Overall, the automated extraction of information from diaries represents a pivotal step toward a more patient-centered approach, where healthcare decisions are based on real-world experiences and tailored to individual needs. The potential usefulness of such data is enormous, as it enables better measurement of everyday experiences and opens new avenues for patient-centered care.
Keywords: multilingual framework, risk assessment, symptom tracking, chronic diseases, patient-centered care, real-world data
Published in DKUM: 12.08.2024; Views: 74; Downloads: 7
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Abstract: The day-to-day work of primary care (PC) was substantially changed by the COVID-19 pandemic. Teaching practices needed to adapt both clinical work and teaching in a way that enabled the teaching process to continue, while maintaining safe and high-quality care. Our study aims to investigate the effect of being a training practice on a number of different outcomes related to the safety culture of PC practices. PRICOV-19 is a multi-country cross-sectional study that researches how PC practices were organized in 38 countries during the pandemic. Data was collected from November 2020 to December 2021. We categorized practices into training and non-training and selected outcomes relating to safety culture: safe practice management, community outreach, professional well-being and adherence to protocols. Mixed-effects regression models were built to analyze the effect of being a training practice for each of the outcomes, while controlling for relevant confounders. Of the participating practices, 2886 (56%) were non-training practices and 2272 (44%) were training practices. Being a training practice was significantly associated with a lower risk for adverse mental health events (OR: 0.83; CI: 0.70-0.99), a higher number of safety measures related to patient flow (Beta: 0.17; CI: 0.07-0.28), a higher number of safety incidents reported (RR: 1.12; CI: 1.06-1.19) and more protected time for meetings (Beta: 0.08; CI: 0.01-0.15). No significant associations were found for outreach initiatives, availability of triage information, use of a phone protocol or infection prevention measures and equipment availability. Training practices were found to have a stronger safety culture than non-training practices. These results have important policy implications, since involving more PC practices in education may be an effective way to improve quality and safety in general practice.
Keywords: safety culture, patient safety, quality of care, primary health care, COVID-19, medical education, vocational training, PRICOV-19, infectious disease, multi-country, general practice
Published in DKUM: 04.07.2024; Views: 128; Downloads: 13
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Abstract: Abstract Background During the Covid-19 pandemic, family medicine practices (FMPs) changed to improve safety against new coronavirus infections for both patients and employees. Protocols for treating patients with suspected Sars-Cov-2 infections were established to protect medical staf and other patients from being infected. However, these protocols also led to increased safety risks, such as delays in treating patients with other medical conditions. This exploratory study aimed to investigate safety risks in treating patients in FMPs during the Covid-19 pandemic and to suggest improvements to prevent Covid-19 in FMPs in Slovenia. Methods A cross-sectional study was rolled out in FMPs in Slovenia as part of the international Pricov-19 study. Data collection on safety management during the Covid-19 pandemic in FMPs in Slovenia took place from November 2020 until January 2021 using a self-administered online survey for FP working in Slovenia. A chi-square test, ANOVA, independent samples t-test or bivariate correlation test was performed to explore associations regarding the safety of patients’ management variables. Results From the 191 participating family physicians (FPs) (15.2% response rate), 54.8% reported having treated patients with fever (not Covid-19) late due to the new protocols at least once, and 54.8% reported patients with urgent conditions having been seen late at least once due to not coming. In the suburbs and rural environments FPs more often reported that at least once patient with a fever (not Covid-19) was seen late due to the protocol (p=0.017) and more often reported that at least once patient with an urgent condition was seen late due to not com‑ ing to their FP (p=0.017). The larger the practice, the more they reported that at least once a patient with fever (not Covid-19) was seen late due to the protocol (p=0.012) and the more they reported at least once a patient with an urgent condition was seen late due to not coming to their FP (p=0.012). Conclusion Covid-19 afected the safety of patient management in FMP in Slovenia. The most common prob‑ lem was foregone care. Therefor, protocols for chronic patient management in the event of epidemics need to be established.
Keywords: Covid-19, family medicine, patient safety, patient management, quality of care, PRICOV-19, primary health care, general practice, timeliness
Published in DKUM: 29.03.2024; Views: 249; Downloads: 15
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Abstract: The article entitled "Patients' genetic data protection in Polish law and EU law - selected issues" presents issues related to the protection of patients' rights and focuses on the legal basis for genetic testing and genetic data protection. Based on a comparison of regulations of international law and regulations on genetic tests introduced in foreign legal systems, the text analyzes the assumptions for the draft of the Polish act on genetic tests performed for health purposes. It presents the patient's consent to testing, the scope of information provided to the patient, the right to disclose research results to related persons and the protection of genetic data. In reference to the regulations set out in other acts, it was noted that they do not guarantee the protection of information obtained as a result of research. Due to the particular nature of genetic data, they require increased protection, which can be guaranteed through implementation of the Act on Genetic Research. In the final part, authors presented the most important achievements of the judicature of European Court of Human Rights in the field of genetic data protection.
Keywords: genetic research, genetic data, protection of genetic data, patient's rights, medical documentation
Published in DKUM: 09.10.2018; Views: 1436; Downloads: 77
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Abstract: The article discusses the relationship between the physician and the patient through different branches of Turkish Law. The author explains the legal theory of physician (as self-employed as well as employed in hospital) – patient relationship in the limits of legislation and court practices, and gives special emphasis on contemporary open questions in Turkish Law. Special intentions is given also to criminal law, duty to inform, liability and consent. The author presents contemporary constitutional and supreme court decision relating to the Casarean, plastic surgery, burden of proof, compensations ...
Keywords: patient, physician, discrimination, criminal law, Turkish law
Published in DKUM: 08.10.2018; Views: 1079; Downloads: 164
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