Voices that matter:The impact of patient-reported outcome measures on clinical decision-making

The critical role of patient-reported outcome measures(PROMs)in enhancing clinical decision-making and promoting patient-centered care has gained a profound significance in scientific research.PROMs encapsulate a patient's health status directly from their perspective,encompassing various domains such as symptom severity,functional status,and overall quality of life.By integrating PROMs into routine clinical practice and research,healthcare providers can achieve a more nuanced understanding of patient experiences and tailor treatments accordingly.The deployment of PROMs supports dynamic patient-provider interactions,fostering better patient engagement and adherence to tre-atment plans.Moreover,PROMs are pivotal in clinical settings for monitoring disease progression and treatment efficacy,particularly in chronic and mental health conditions.However,challenges in implementing PROMs include data collection and management,integration into existing health systems,and acceptance by patients and providers.Overcoming these barriers necessitates technological advancements,policy development,and continuous education to enhance the acceptability and effectiveness of PROMs.The paper concludes with recommendations for future research and policy-making aimed at optimizing the use and impact of PROMs across healthcare settings.

Studies on Multi-Criteria Decision-Making-Based Healthcare Systems Using the Machine Learning

There is a lot of information in healthcare and medical records.However,it is challenging for humans to turn data into information and spot hidden patterns in today’s digitally based culture.Effective decision support technologies can help medical professionals find critical information concealed in voluminous data and support their clinical judgments and in different healthcare management activities.This paper presented an extensive literature survey for healthcare systems using machine learning based on multi-criteria decision-making.Various existing studies are considered for review,and a critical analysis is being done through the reviews study,which can help the researchers to explore other research areas to cater for the need of the field.

Digital Disparities:How Artificial Intelligence Can Facilitate Anti-Black Racism in the U.S.Healthcare Sector

This paper delves into the intricate interplay between artificial intelligence(AI)systems and the perpetuation of Anti-Black racism within the United States medical industry.Despite the promising potential of AI to enhance healthcare outcomes and reduce disparities,there is a growing concern that these technologies may inadvertently/advertently exacerbate existing racial inequalities.Focusing specifically on the experiences of Black patients,this research investigates how the following AI components:medical algorithms,machine learning,and natural learning processes are contributing to the unequal distribution of medical resources,diagnosis,and health care treatment of those classified as Black.Furthermore,this review employs a multidisciplinary approach,combining insights from computer science,medical ethics,and social justice theory to analyze the mechanisms through which AI systems may encode and reinforce racial biases.By dissecting the three primary components of AI,this paper aims to present a clear understanding of how these technologies work,how they intersect,and how they may inherently perpetuate harmful stereotypes resulting in negligent outcomes for Black patients.Furthermore,this paper explores the ethical implications of deploying AI in healthcare settings and calls for increased transparency,accountability,and diversity in the development and implementation of these technologies.Finally,it is important that I prefer the following paper with a clear and concise definition of what I refer to as Anti-Black racism throughout the text.Therefore,I assert the following:Anti-Black racism refers to prejudice,discrimination,or antagonism directed against individuals or communities of African descent based on their race.It involves the belief in the inherent superiority of one race over another and the systemic and institutional practices that perpetuate inequality and disadvantage for Black people.Furthermore,I proclaim that this form of racism can be manifested in various ways,such as unequal access to opportunities,resources,education,employment,and fair treatment within social,economic,and political systems.It is also pertinent to acknowledge that Anti-Black racism is deeply rooted in historical and societal structures throughout the U.S.borders and beyond,leading to systemic disadvantages and disparities that impact the well-being and life chances of Black individuals and communities.Addressing Anti-Black racism involves recognizing and challenging both individual attitudes and systemic structures that contribute to discrimination and inequality.Efforts to combat Anti-Black racism include promoting awareness,education,advocacy for policy changes,and fostering a culture of inclusivity and equality.

Optimizing Healthcare Outcomes through Data-Driven Predictive Modeling

This study investigates the transformative potential of big data analytics in healthcare, focusing on its application for forecasting patient outcomes and enhancing clinical decision-making. The primary challenges addressed include data integration, quality, privacy issues, and the interpretability of complex machine-learning models. An extensive literature review evaluates the current state of big data analytics in healthcare, particularly predictive analytics. The research employs machine learning algorithms to develop predictive models aimed at specific patient outcomes, such as disease progression and treatment responses. The models are assessed based on three key metrics: accuracy, interpretability, and clinical relevance. The findings demonstrate that big data analytics can significantly revolutionize healthcare by providing data-driven insights that inform treatment decisions, anticipate complications, and identify high-risk patients. The predictive models developed show promise for enhancing clinical judgment and facilitating personalized treatment approaches. Moreover, the study underscores the importance of addressing data quality, integration, and privacy to ensure the ethical application of predictive analytics in clinical settings. The results contribute to the growing body of research on practical big data applications in healthcare, offering valuable recommendations for balancing patient privacy with the benefits of data-driven insights. Ultimately, this research has implications for policy-making, guiding the implementation of predictive models and fostering innovation aimed at improving healthcare outcomes.

Right to Health or the Human Right of Access to Essential Healthcare

The Universal Declaration of Human Rights refers to the human right to health and well-being including medical care, but for the majority of people whom are not covered by health insurance this is better said than done. Ensuring the access of all citizens to the needed medical care requires the provision of health insurance coverage to a population pool and gradually expanding the pool to the whole nation. The ethical perspective of pooling resources across various groups of people with different levels of income and different health risks associated with age, genetics, and lifestyle, may raise the issue of individual autonomy versus social solidarity. Governmental, social, private, and community-based healthcare coverage have been used in different countries with varying details in the sources of funding, pooling of contributions, and the purchase of the covered healthcare services; these models have had varying levels of success depending on not only the availability of funds, but also on the political commitment of the state and the social solidarity and cultural attitude of the population towards universal healthcare. Therefore, universal healthcare requires not only a certain level of economic development, but also a strong sense of solidarity among the people as well as a political commitment in their government. I argue that the statement regarding the right to health, well-being, and medical care needs to be rethought, and instead universal access to essential healthcare should be regarded as a basic human right.

On the System of Rights Underlying the Right to Health and Constraints on the Right to Health——Including a Commentary on the Basic Healthcare and Health promotion Law(Draft)

Conceptually,health is subjective,procedural and socially reliant.This three-fold nature determines the connotations of the right to health as well as the constraints thereof.The right to health encompasses both the right to freedom and social rights.The right to freedom in the context of health means that the state should respect the health status and choices of its citizens and trust that the people are able to optimize their health through their own efforts,whereas the right to basic healthcare services is an important component of the right to health from the perspective of social rights.The review system stipulated in administrative normative documents increases,to a certain degree,the possibility that citizens can realize their right to health.The right to health is constrained in three aspects:"precondition of the possible",concurrent requirements imposed by society and conflicts among basic rights.When there is financial restraint on what the state can afford,the right to health is constrained by limits to healthcare institutions and the provision of healthcare services.over-emphasis of individual responsibility on the part of the insured can possibly transform the right to health into an obligation to be healthy.

Perception of Universal Healthcare among College Students, Faculty, and Staff at the University of Evansville

The U.S. is a country founded on freedoms protected by our constitution. A debate rages currently about whether healthcare is a human right. We conducted a survey at the University of Evansville regarding perceptions of Universal Healthcare among students, faculty, and staff in the College of Education and Health Sciences. Over ninety percent of those who responded agreed that healthcare was a human right. This indicates a strong need for better policy discussion that includes the voice of the everyday person.

In Bangla There Is No Word for Vagina —Reflections on Language, Sexual Health, and Women’s Access to Healthcare in Resource-Limited Countries

Language plays a central role in how gender and sexuality are described. In Bangla or Bengali, physicians, when educating and counseling women patients, do not have a socially acceptable word for “vagina”. If language is missing for female genitalia or important female sexual functions, could this absence reflect on the position of women in society, reproductive rights, and access to healthcare? Is there a relationship between language and the high rates of the gender-based cervical and breast cancers in some low and middle-income countries? This commentary examines scholarship on the topic of language, the female body, gender-based violence, disparities of healthcare for women, and the consequences of language on sexual attitudes and health.

Challenges of Obtaining Informed Consent in Poorly Coordinated and Funded Healthcare Services: Papua New Guinea Situation

During a semi-structured interview we ask the participants several questions based on the perceived role of the interviewee within the informed consent process.We asked questions pertaining to how informed consent unravels itself across barriers.Few question topics included how the issue of socio-economic,geography and custom of the people are addressed,and how the medical professionals deal with different groups of people and how the interviewees understood informed consent.Interviews for each group were asked with different sets of questions and were open enough to allow for probing questions in order to gain additional information when the opportunity presented itself.The data were analyzed using interpretative approaches and the various themes and concepts from each question and response qualitatively counted and uncovered patterns in the various group perspectives.We examined the participants’perspectives and opinions using a visual table for comparing themes and concepts,and we presented the interviewees’views.

A Healthcare System for Internet of Things (IoT) Application: Machine Learning Based Approach

Internet of things (IoT) has become an interesting topic in the field of technological research. It is basically interconnecting of devices with each other over the internet. Beside its general use in terms of autonomous cars and smart homes, but some of the best applications of IoT technology in fields of health care monitoring is worth mentioning. The main purpose of this research work is to provide comport services for patients. It can be used to promote basic nursing care by improving the quality of care and patient safety from patient home environment. Rural area of a country lacks behind the proper patient monitoring system. So, remote monitoring and prescribing by sharing medical information in an authenticated manner is very effective for betterment of medical facilities in rural area. We have proposed a healthcare system which can analyze ECG report using supervise machine learning techniques. Analyzing report can be stored in cloud platform which can be further used to prescribe by the experienced medical practitioner. For performance evaluation, ECG data is analyzed using six supervised machine learning algorithms. Data sets are divided into two groups: 75 percent data for training the model and rest 25 percent data for testing. To avoid any kind of anomalies or repetitions, cross validation and random train-test split was used to obtain the result as accurate as possible.

Healthcare bioethics: a new proposal of ethics for clinical practice

The expression“patient revolution”is the social,educational,cultural,and political movement initiated at the end of the twentieth century and beginning of the twenty-first century,which sustains the protagonism of the patients in their care as the primary decision maker and holder of human rights.The patient revolution comprises varied approaches and references,such as Patient-Centered Care,Shared Decision-Making,Patient Participation,and Patients’Rights,which combine to uphold that the patient is a moral agent and anchor healthcare in the biopsychosocial model.In this sense,this movement is a new proposal of ethics for clinical practice.This theoretical research primary goal is to develop theoretical contributions that support this new Bioethics dimension,emphasizing the context in healthcare that calls for new ethics in clinical practice,characterized as a patient revolution movement.We concluded that the patient revolution had driven a new paradigm in healthcare based on Patient-Centricity,SDM,and Patients’Rights.Despite this critical change in the health sphere,the patient revolution appears to have reverberated in clinical bioethics.Thus,theoretical contributions must be developed for new ethics in the clinic,a task undertaken in this article through the proposal of Healthcare Bioethics as an adequate frame of reference to be adopted at all levels of clinical care.Thus,it is concluded that having Bioethics Healthcare as a beacon of ethics in clinical encounters can contribute to the quality of care and its ethical provision,confronting practices that violate Patients’Rights.It is imperative to change paternalistic theoretical frameworks that mitigate the Patients’Right to participate in every decision regarding their health.Only with the adoption of new approaches and an insight into the patient’s role in clinical interaction can a new culture in Patient-Centered healthcare take shape.

A Research Report on the Prescription Rights of Chinese Nurses

Objective: To explore the feasibility of the nurse’ s prescription right in China, to develop the requirements for the qualification of the ap-plicant for the prescription right of nurse, and to determine the content of certain prescriptions in the specific circumstances. Methods: Literature review on the relevant articles/material with the contents of the nurse’ s right of prescription home and a-broad. Semi-structured depth interview method was used to interview 18 experts on whether the nurses can participate in the graded nursing decision and whether nurses with certain ability can make the decision. Using the self-made questionnaire“Nur-ses involved in graded nursing decision-recognition questionnaire”, 553 nurses completed questionnaires on willingness to nurse decision-making grading. Using the analytic hierarchy process, the 23 experts’ judgment on the main body of the graded nurs-ing was rated. Using semi-structured depth interview method, 17 experts were interviewed on the graded nursing quality assess-ment and training outline. The form of expert personal judgment and the“grading nursing qualification experts predict question-naire”were used as a preliminary designing tool, 32 experts were asked to predict the graded nursing quality. The relatively im-portant factors that might promote implementation of right of Chinese nurse prescribing weights setting were obtained by analytic hierarchy process. Using Delphi method, 2 rounds of consultation to 291 experts/times were performed, and determined its con-tent on the fields of graded nursing decision, nurses’ job description, decision making nurse in graded nursing work process and related management system, decision-making main body of clinical nursing, nurse authority of prescription application qualifi-cation, clinical nurses, diabetes specialist nurses, tumor specialist nurses, nurses in emergency department, community nurses in certain circumstances writing prescription, and nursing undergraduate added with nurse authority of prescription related courses. Results: The physician is not considered to be the best decision-making main body of clinical nursing work and graded nurs-ing, nurses can participate in the work of decision-making. The qualification of hierarchical decision-making nurse and nurse prescribing applicants have been determined. The hierarchical nursing decision-making nurses’ position description and training outline have been compiled. Experts suggest that clinical nurses with certain qualifications should be given the rights of some prescription form ( independent prescription, prescription, prescription protocol extension) to prescribe specific drugs in high fe-ver, hypoglycemia, hypertension, anaphylactic shock and other 11 specific circumstances. The nurses of the diabetes should be given the right of prescribing sulfonylureas, biguanides, glucosidase inhibitor, and protamine zinc insulin, and the right to write the prescription and consultation for part of medical equipment, health education, and four routine tests, which contains blood sugar monitoring, urine glucose monitoring, glycosylated hemoglobin assay, and oral glucose tolerance test. Tumor specialist nurses should be given the right to write the prescription of 7 specific circumstances including blood routine tests, electrocardio-gram, blood biochemistry and other 9 laboratory tests, constipation, phlebitis, and cancer pain, and the right of 5 tumor emer-gency prescription including chemotherapy drug allergy, hemorrhagic shock, acute upper gastrointestinal bleeding. Nurses in e-mergency department with certain qualification should be given the right to prescribe specific drugs in 15 circumstances which include cardiac arrest, ventricular fibrillation, and acute cardiogenic chest pain. Community nurses with certain qualification should be given the right to write the prescriptions on 14 contents including disinfection and cleaning, sterile infusion type, and wound care products. Experts suggest that nursing undergraduate education in China should be added with 2 courses which are prescription rights related laws and regulations and nursing intervention, and that pharmacology course should be supplemented with related course in order to adapt to the implementation of nurse prescribing rights. Conclusions: China’ s nurses with certain qualification or after special training have the ability to accept and should be given the right of prescriptions in certain circumstance within the scope of their work.

How Load Aggregators Avoid Risks in Spot Electricity Market:In the Framework of Power Consumption Right Option Contracts

There is uncertainty in the electricity price of spot electricity market,which makes load aggregators undertake price risks for their agent users.In order to allow load aggregators to reduce the spot market price risk,scholars have proposed many solutions,such as improving the declaration decision-making model,signing power mutual insurance contracts,and adding energy storage and mobilizing demand-side resources to respond.In terms of demand side,calling flexible demand-side resources can be considered as a key solution.The user’s power consumption rights(PCRs)are core contents of the demand-side resources.However,there have been few studies on the pricing of PCR contracts and transaction decisions to solve the problem of price forecast deviation and to manage the uncertainty of spot market prices.In addition,in traditional PCR contracts,PCRs are mostly priced using a single price mechanism,that is,the power user is compensated for part of the electricity that was interrupted or reduced in power supply.However,some power users might engage in speculative behaviours under this mechanism.Further,for load aggregators,their price risk avoidance ability has not substantially improved.As a financial derivative,options can solve the above problems.In this article,firstly,the option method is used to build an option pricing optimization model for power consumption right contracts that can calculate the optimal option premium and strike price of option contracts of power consumption rights.Secondly,from the perspective of power users and load aggregators,a simulation model of power consumption right transaction decision-making is constructed.The results of calculation examples show that(1)Under the model in this article,the pricing of option contracts for power consumption rights with better risk aversion capabilities than traditional compensation contracts can be obtained.(2)The decision to sell or purchase the power consumption rights will converge at respective highvalue periods,and option contracts will expedite the process.(3)Option contracts can significantly reduce the loss caused by the uncertainty of spot electricity prices for load aggregators without reducing users’willingness to sell power consumption rights.

Development of Patient Rights and Analysis of Patient Complaints in Turkey

The aim of this study is to identify the development of patient rights in Turkey and to analyze patient complaints in the country. An attempt was made to determine how the issues discussed in patient rights committees are differentiated from the applications made to the patient rights units of the hospitals within the body of Ministry of Health in 2009, depending on variables such as branch, province, region, hospital type, title, gender, and subject of application, 18,634 applications were content analysed after they were classified in terms of subject, unit, title, branch, province, and region, and were transformed into numerical codes to prepare the data for analysis. The results show on a regional basis that Marmara is in the first place with 34.9% and East Anatolia is in the last place with 4.6%. The unit receiving the most complaints is outpatient services with 43.1%. Regarding position title, specialists ranked first with 37.9% and managers ranked next with 11.3%. When reviewing the subjects of the applications, they are ranked as follows： （1） lack of benefiting from the services （44%）; and （2） lack of receiving respect and comfort （26.8%）. Patient rights violations were detected in 12.7% but not in 51.6% of the applications made.

健康医疗数据权利归属制度构建:现状、必要性与关注点

分析了健康医疗数据在市场利用、制度规范和学术理论3个方面的现实状况,总结了健康医疗数据因权利归属制度缺失所导致市场发展过程中的问题,进而得出建立健康医疗数据权利归属的必要性。结合学术界对数据权利配置相关的理论成果以及健康医疗数据所具有的强敏感性与隐私性、法律及伦理要求的特殊性、参与者身份特定、数据排他性4个方面的特点,从隐私与敏感信息保护、数据归属原则设计以及配套的数据利用机制建设等方面对健康医疗数据权利归属制度建设提出了建议。

健康医疗大数据治理的健康权面向

健康医疗大数据的社会价值与科学价值日益受到重视,当前关于健康医疗大数据治理的个人自决模式和积极利用模式均存在相应的问题,从健康权的角度理解健康医疗大数据治理有利于解决这些问题。健康权是当代人权的重要内容,健康医疗大数据应用可以在提高健康决策能力、实现健康资源的公平合理分配、增进健康服务水平、扩展国民健康参与等方面促进健康权的实现,但也可能在对隐私保护、违反不歧视和平等保护原则、过度商业化等方面影响健康权实现,其利益分配也值得关注。从国家对健康权的尊重义务、保护义务和实现(促进)义务的角度,有助于理解国家对健康医疗大数据的治理措施。具体而言,应当从社会共治的角度理解知情同意原则,根据数据来源不同采用不同授权机制,对不同的数据应用场景进行类型化规制,并在数据利用的收益分配方面充分考虑公众健康需求。

罕见病药品可及性的伦理考量与策略探索

在罕见病药品可及性方面,我们仍面临着诸多不容忽视的伦理问题,包括企业以经济效益为导向、缺乏大规模的临床研究、医疗机构缺乏采购罕见病药品的激励机制、超说明书使用罕见病药品、资源不公平分配、支付政策不完善等伦理学问题。因此,国家应完善罕见病药品的鼓励政策,强化企业社会责任,确保药品供应稳定。尊重患者临床试验权益,保障伦理安全。医疗机构需以临床需求为导向,确保药品可及性,并规范超说明书使用,保障患者健康权。国家医保政策应关注罕见病患者,建立多方参与的保障机制,促进药品公平可及。

Artificial intelligence as a tool in drug discovery and development

The rapidly advancing field of artificial intelligence(AI)has garnered substantial attention for its potential application in drug discovery and development.This opinion review critically examined the feasibility and prospects of integrating AI as a transformative tool in the pharmaceutical industry.AI,encompassing machine learning algorithms,deep learning,and data analytics,offers unprecedented opportunities to streamline and enhance various stages of drug development.This opinion review delved into the current landscape of AI-driven approaches,discussing their utilization in target identification,lead optimization,and predictive modeling of pharmacokinetics and toxicity.We aimed to scrutinize the integration of large-scale omics data,electronic health records,and chemical informatics,highlighting the power of AI in uncovering novel therapeutic targets and accelerating drug repurposing strategies.Despite the considerable potential of AI,the review also addressed inherent challenges,including data privacy concerns,interpretability of AI models,and the need for robust validation in realworld clinical settings.Additionally,we explored ethical considerations surrounding AI-driven decision-making in drug development.This opinion review provided a nuanced perspective on the transformative role of AI in drug discovery by discussing the existing literature and emerging trends,presenting critical insights and addressing potential hurdles.In conclusion,this study aimed to stimulate discourse within the scientific community and guide future endeavors to harness the full potential of AI in drug development.

知识产权视角下健康医疗数据保护之研究

健康医疗数据与知识产权的保护客体具有高度相似性,因此知识产权制度在理论上具有调整健康医疗数据的适配性。但健康医疗数据是数字化时代下的新兴产物,有不同于知识产权之保护客体的独有特征,这就导致在利用知识产权制度来调整健康医疗数据时会面临适用困境,故有必要对健康医疗数据保护进行专门制度的设计。健康医疗数据的法律保护路径之完善可以借鉴现有知识产权制度的原理,以产权明确、数据流通共享、利益平衡等原则为基础,设置专门的法律规范,加强个人对健康医疗数据的控制权,并提高对健康医疗数据管理的监管程度,对健康医疗数据的共享使用进行规范性的构造。

公立医疗机构产权改革模式分析

在我国正在进行公立医疗机构的产权改革。股份制和合同委托管理是两种主要的公立产权改革模式。一些公立 医疗机构将部分或者全部的公立产权出售给私人企业,也有个别的城市,将大部分医疗机构出售给社会的私立投资者。