Purpose: This research aims to evaluate the potential threats to patient privacy and confidentiality posed by mHealth applications on mobile devices. Methodology: A comprehensive literature review was conducted, selec...Purpose: This research aims to evaluate the potential threats to patient privacy and confidentiality posed by mHealth applications on mobile devices. Methodology: A comprehensive literature review was conducted, selecting eighty-eight articles published over the past fifteen years. The study assessed data gathering and storage practices, regulatory adherence, legal structures, consent procedures, user education, and strategies to mitigate risks. Results: The findings reveal significant advancements in technologies designed to safeguard privacy and facilitate the widespread use of mHealth apps. However, persistent ethical issues related to privacy remain largely unchanged despite these technological strides.展开更多
Publication biases and collection limitations are the main disadvantages of a traditional meta-analysis based on aggregate patient data（APD）from published articles.Individual patient data（IPD）meta-analysis,as the ...Publication biases and collection limitations are the main disadvantages of a traditional meta-analysis based on aggregate patient data（APD）from published articles.Individual patient data（IPD）meta-analysis,as the gold standard of systematic review,is a possible alternative in this context.However,the publications relative to IPD meta-analyses are still rare compared with the traditional ones,especially in the research oriented to Chinese medicine（CM）.In this article,the strengths and detailed functioning of IPD meta-analysis are described.Furthermore,the need for IPD meta-analysis to assess the treatments based on CM was also discussed.Compared with the traditional APD meta-analysis,the IPD meta-analysis might give a more accurate and unbiased assessment and is worth to be recommended to CM researchers.展开更多
BACKGROUND Lutetium has been shown to be an important potential innovation in pre-treated metastatic castration-resistant prostate cancer.Two clinical trials have evaluated lutetium thus far(therap and vision with 99 ...BACKGROUND Lutetium has been shown to be an important potential innovation in pre-treated metastatic castration-resistant prostate cancer.Two clinical trials have evaluated lutetium thus far(therap and vision with 99 and 385 patients,respectively),but their results are discordant.AIM To synthetize the available evidence on the effectiveness of lutetium in pre-treated metastatic castration-resistant prostate cancer;and to test the application of a new artificial intelligence technique that synthetizes effectiveness based on reconstructed patient-level data.METHODS We employed a new artificial intelligence method(shiny method)to pool the survival data of these two trials and evaluate to what extent the lutetium cohorts differed from one another.The shiny technique employs an original reconstruction of individual patient data from the Kaplan-Meier curves.The progression-free survival graphs of the two lutetium cohorts were analyzed and compared.RESULTS The hazard ratio estimated was in favor of the vision trial;the difference was statistically significant(P<0.001).These results indicate that further studies on lutetium are needed because the survival data of the two trials published thus far are conflicting.CONCLUSION Our study confirms the feasibility of reconstructing patient-level data from survival graphs in order to generate a survival statistics.展开更多
Objective The trial was designed to evaluate the safety and performance of the ev3 Protégé TM stent in the treatment of de novo or re-stenotic common and/or internal carotid artery stenoses with adjunctive u...Objective The trial was designed to evaluate the safety and performance of the ev3 Protégé TM stent in the treatment of de novo or re-stenotic common and/or internal carotid artery stenoses with adjunctive use of a CE-marked filter embolic protection device.Methods This study was a prospective multi-center, single-arm trial. Between June and October 2003, 77 patients were enrolled in 8 investigational centers throughout Europe. The primary endpoint was the incidence of Major Neurological Events (MANE) through one month. Other endpoints were the ability to properly place the stent, and primary patency and MANE after six months. Eligible for the study were patients with a de novo or restenotic target lesion located in the common and/or internal carotid artery (>70% stenosis for asymptomatic and >50% stenosis for symptomatic patients). The ev3 Spider (Embolic Protection Filter was used in 75 of 77 cases. Results In 76 out of the 77 patients (99%), the stent could be successfully implanted with a residual stenosis ≤30% as criterion. Of the 74 patients that had a carotid ultrasound at one month follow-up, none had a re-stenosis of the target lesion. There were three MANEs during or immediately after the procedure (3.9%), two were major and one was a minor stroke. There were eight severe complications (9.1%); six of these happened during or immediately after the procedure and were related to the procedure, none was related to the device. They are resolved without sequelae. No deaths have occurred.Conclusions The Protégé stent is safe and performs well in the treatment of carotid artery stenosis. The technical success rate for placement of the Protégé stent as assessed by the residual stenosis post implant was very high and all stents were successfully deployed. The incidence of MANE was comparable with that in other recent carotid stent studies and still lower than standard CEA.展开更多
目的梳理分析健康医疗数据共享背景下中国患者隐私保护相关研究现状,以期为未来相关领域的研究提供参考。方法检索2018—2023年中国知网、万方数据库中有关患者隐私保护的期刊文献,使用Cite Space 6.2.R5软件进行关键词聚类分析和关键...目的梳理分析健康医疗数据共享背景下中国患者隐私保护相关研究现状,以期为未来相关领域的研究提供参考。方法检索2018—2023年中国知网、万方数据库中有关患者隐私保护的期刊文献,使用Cite Space 6.2.R5软件进行关键词聚类分析和关键词突现分析,结合文献具体内容梳理患者隐私保护研究现状。结果共纳入1590篇文献进行分析;发文量最多的核心期刊为《中国医学伦理学》(54篇,3.40%);中国患者隐私保护领域研究现状可概括为医疗护理活动相关隐私问题、医疗服务新技术引发的隐私问题以及特殊情境下的隐私问题;关键词突现分析显示“个人信息”“数据共享”是当前热点研究主题。结论健康医疗数据共享背景下,患者隐私保护仍是研究热点及重点。目前研究对患者隐私保护的定义较为局限,建议未来从多角度出发,深入挖掘多方对于隐私保护的认识,丰富患者隐私保护内涵。此外,还需加强医务人员患者隐私保护意识和行为实践培养,不断实践患者隐私保护技术的安全性及有效性,进一步完善特殊时期及健康数据共享背景下的个人隐私保护相关立法。展开更多
瑞士在个性化医疗领域享有很高的声誉。“瑞士个性化健康网络”(Swiss Personalized Health Network,SPHN)以其高效率、高私密性、高技术以及卓越的服务质量而著称,常被视为全球医疗服务的典范。本研究聚焦于SPHN对瑞士个性化医疗的重...瑞士在个性化医疗领域享有很高的声誉。“瑞士个性化健康网络”(Swiss Personalized Health Network,SPHN)以其高效率、高私密性、高技术以及卓越的服务质量而著称,常被视为全球医疗服务的典范。本研究聚焦于SPHN对瑞士个性化医疗的重要支撑作用,调研了瑞士个性化医疗的战略动向、政策法律支撑和组织机构运营,并且认为以下3个方面是瑞士个性化医疗长期在欧洲维持创新高地的关键因素:①SPHN组织的高效运营;②患者数据共享的特别保护机制;③可操作性极强的数据共享基础设施。在自上而下和自下而上的资金支持基础上,SPHN实现了大学附属医院、大学、技术平台、患者和其他数据生产机构等多方利益主体的平衡,搭建了高度发达的数据互操作性框架,并在中央数据协调中心(DCC)负责下建设了BioMedIT等一系列重大数据共享基础设施,以便实际支撑研发计划的科研项目,适应机器学习、人工智能算法以及多组学分析技术的进一步应用。未来,瑞士还计划在个性化医疗发展的“顶层设计”中,逐步强化个性化医疗数据共享以完善全生命周期纵向数据,加强数据共享对多重慢病诊断的支持,这在一定程度上代表了欧洲个性化医疗发展的最新动向。展开更多
There are two common types of adult patient with a short bowel, those with jejunum in continuity with a functioning colon and those with a jejunostomy. Both groups have potential problems of undernutrition, but this i...There are two common types of adult patient with a short bowel, those with jejunum in continuity with a functioning colon and those with a jejunostomy. Both groups have potential problems of undernutrition, but this is a greater problem in those without a colon, as they do not derive energy from anaerobic bacterial fermentation of carbohydrate to short chain fatty acids in the colon. Patients with a jejunostomy have major problems of dehydration, sodium and magnesium depletion all due to a large volume of stomal output. Both types of patient have lost at least 60 cm of terminal ileum and so will become deficient of vitamin B(12). Both groups have a high prevalence of gallstones (45%) resulting from periods of biliary stasis. Patients with a retained colon have a 25% chance of developing calcium oxalate renal stones and they may have problems with D(-) lactic acidosis. The survival of patients with a short bowel, even if they need long-term parenteral nutrition, is good.展开更多
文摘Purpose: This research aims to evaluate the potential threats to patient privacy and confidentiality posed by mHealth applications on mobile devices. Methodology: A comprehensive literature review was conducted, selecting eighty-eight articles published over the past fifteen years. The study assessed data gathering and storage practices, regulatory adherence, legal structures, consent procedures, user education, and strategies to mitigate risks. Results: The findings reveal significant advancements in technologies designed to safeguard privacy and facilitate the widespread use of mHealth apps. However, persistent ethical issues related to privacy remain largely unchanged despite these technological strides.
基金Supported by the Fundamental Research Funds for the CentralPublic Welfare Research Institutes of China(No.ZZ070818 andZ0259)National Natural Science Foundation of China(No.81072920 and 81303149)
文摘Publication biases and collection limitations are the main disadvantages of a traditional meta-analysis based on aggregate patient data（APD）from published articles.Individual patient data（IPD）meta-analysis,as the gold standard of systematic review,is a possible alternative in this context.However,the publications relative to IPD meta-analyses are still rare compared with the traditional ones,especially in the research oriented to Chinese medicine（CM）.In this article,the strengths and detailed functioning of IPD meta-analysis are described.Furthermore,the need for IPD meta-analysis to assess the treatments based on CM was also discussed.Compared with the traditional APD meta-analysis,the IPD meta-analysis might give a more accurate and unbiased assessment and is worth to be recommended to CM researchers.
文摘BACKGROUND Lutetium has been shown to be an important potential innovation in pre-treated metastatic castration-resistant prostate cancer.Two clinical trials have evaluated lutetium thus far(therap and vision with 99 and 385 patients,respectively),but their results are discordant.AIM To synthetize the available evidence on the effectiveness of lutetium in pre-treated metastatic castration-resistant prostate cancer;and to test the application of a new artificial intelligence technique that synthetizes effectiveness based on reconstructed patient-level data.METHODS We employed a new artificial intelligence method(shiny method)to pool the survival data of these two trials and evaluate to what extent the lutetium cohorts differed from one another.The shiny technique employs an original reconstruction of individual patient data from the Kaplan-Meier curves.The progression-free survival graphs of the two lutetium cohorts were analyzed and compared.RESULTS The hazard ratio estimated was in favor of the vision trial;the difference was statistically significant(P<0.001).These results indicate that further studies on lutetium are needed because the survival data of the two trials published thus far are conflicting.CONCLUSION Our study confirms the feasibility of reconstructing patient-level data from survival graphs in order to generate a survival statistics.
文摘Objective The trial was designed to evaluate the safety and performance of the ev3 Protégé TM stent in the treatment of de novo or re-stenotic common and/or internal carotid artery stenoses with adjunctive use of a CE-marked filter embolic protection device.Methods This study was a prospective multi-center, single-arm trial. Between June and October 2003, 77 patients were enrolled in 8 investigational centers throughout Europe. The primary endpoint was the incidence of Major Neurological Events (MANE) through one month. Other endpoints were the ability to properly place the stent, and primary patency and MANE after six months. Eligible for the study were patients with a de novo or restenotic target lesion located in the common and/or internal carotid artery (>70% stenosis for asymptomatic and >50% stenosis for symptomatic patients). The ev3 Spider (Embolic Protection Filter was used in 75 of 77 cases. Results In 76 out of the 77 patients (99%), the stent could be successfully implanted with a residual stenosis ≤30% as criterion. Of the 74 patients that had a carotid ultrasound at one month follow-up, none had a re-stenosis of the target lesion. There were three MANEs during or immediately after the procedure (3.9%), two were major and one was a minor stroke. There were eight severe complications (9.1%); six of these happened during or immediately after the procedure and were related to the procedure, none was related to the device. They are resolved without sequelae. No deaths have occurred.Conclusions The Protégé stent is safe and performs well in the treatment of carotid artery stenosis. The technical success rate for placement of the Protégé stent as assessed by the residual stenosis post implant was very high and all stents were successfully deployed. The incidence of MANE was comparable with that in other recent carotid stent studies and still lower than standard CEA.
文摘目的梳理分析健康医疗数据共享背景下中国患者隐私保护相关研究现状,以期为未来相关领域的研究提供参考。方法检索2018—2023年中国知网、万方数据库中有关患者隐私保护的期刊文献,使用Cite Space 6.2.R5软件进行关键词聚类分析和关键词突现分析,结合文献具体内容梳理患者隐私保护研究现状。结果共纳入1590篇文献进行分析;发文量最多的核心期刊为《中国医学伦理学》(54篇,3.40%);中国患者隐私保护领域研究现状可概括为医疗护理活动相关隐私问题、医疗服务新技术引发的隐私问题以及特殊情境下的隐私问题;关键词突现分析显示“个人信息”“数据共享”是当前热点研究主题。结论健康医疗数据共享背景下,患者隐私保护仍是研究热点及重点。目前研究对患者隐私保护的定义较为局限,建议未来从多角度出发,深入挖掘多方对于隐私保护的认识,丰富患者隐私保护内涵。此外,还需加强医务人员患者隐私保护意识和行为实践培养,不断实践患者隐私保护技术的安全性及有效性,进一步完善特殊时期及健康数据共享背景下的个人隐私保护相关立法。
文摘瑞士在个性化医疗领域享有很高的声誉。“瑞士个性化健康网络”(Swiss Personalized Health Network,SPHN)以其高效率、高私密性、高技术以及卓越的服务质量而著称,常被视为全球医疗服务的典范。本研究聚焦于SPHN对瑞士个性化医疗的重要支撑作用,调研了瑞士个性化医疗的战略动向、政策法律支撑和组织机构运营,并且认为以下3个方面是瑞士个性化医疗长期在欧洲维持创新高地的关键因素:①SPHN组织的高效运营;②患者数据共享的特别保护机制;③可操作性极强的数据共享基础设施。在自上而下和自下而上的资金支持基础上,SPHN实现了大学附属医院、大学、技术平台、患者和其他数据生产机构等多方利益主体的平衡,搭建了高度发达的数据互操作性框架,并在中央数据协调中心(DCC)负责下建设了BioMedIT等一系列重大数据共享基础设施,以便实际支撑研发计划的科研项目,适应机器学习、人工智能算法以及多组学分析技术的进一步应用。未来,瑞士还计划在个性化医疗发展的“顶层设计”中,逐步强化个性化医疗数据共享以完善全生命周期纵向数据,加强数据共享对多重慢病诊断的支持,这在一定程度上代表了欧洲个性化医疗发展的最新动向。
文摘There are two common types of adult patient with a short bowel, those with jejunum in continuity with a functioning colon and those with a jejunostomy. Both groups have potential problems of undernutrition, but this is a greater problem in those without a colon, as they do not derive energy from anaerobic bacterial fermentation of carbohydrate to short chain fatty acids in the colon. Patients with a jejunostomy have major problems of dehydration, sodium and magnesium depletion all due to a large volume of stomal output. Both types of patient have lost at least 60 cm of terminal ileum and so will become deficient of vitamin B(12). Both groups have a high prevalence of gallstones (45%) resulting from periods of biliary stasis. Patients with a retained colon have a 25% chance of developing calcium oxalate renal stones and they may have problems with D(-) lactic acidosis. The survival of patients with a short bowel, even if they need long-term parenteral nutrition, is good.
基金the project“Improving quality of care for people with dementia in the acute care setting(eQC)”which is funded by the National Health and Medical Research Council(NHMRC)of the Australian Government(ID:APP1140459).
