Shaoma Zhijing granule for children with tic disorders: A rapid health technology assessment

Objective:To rapidly assess the effectiveness,safety,economy,and applicability of Shaoma Zhijing granule(SZG)for the treatment of children with tic disorders(TD),and provide currently available best evidence for decision-makers of health policies.Methods:We conducted a rapid health technology assessment(RHTA)to explore the value of SZG.A systematic literature search in eight literature databases and on three clinical trial registration platforms was performed.The literature was screened according to eligibility criteria.The screening process and data extraction were conducted by two reviewers,and the quality of the literature was also assessed.The results were summarized,analyzed,and presented in tables or figures.Results:A total of five randomized controlled trials(RCTs)were included in this study,of which one was published in English(in the Journal of Child Psychology and Psychiatry)and four in Chinese journals.The overall risk of bias for the five RCTs was evaluated as“some concerns.”SZG monotherapy or in combi-nation with tiapride was better than tiapride alone in improving traditional Chinese medicine(TCM)syndromes and tic symptoms,with a daily cost of¥67.50e107.22.Adverse events were mainly related to the digestive,respiratory,and neurological systems,but all were mild.Conclusion:Overall,the current RHTA of published,peer-reviewed literature has located a small body of evidence evaluating the use of SZG for the treatment of TD in children.SZG has effects on improving TCM syndromes and tic symptoms;the daily cost is¥67.50e107.22;and all adverse events are mild.High-quality studies with long-term follow-up should be conducted,so as to provide local evidence and consistently guide and improve scientific decision-making.

Intensive care environment: Perspective of relatives of critically ill patient sustained by health technology

The intensive care unit(ICU)is a complex setting by nature,and some have described it as bizarre due to its numerous sirens that sound when anything is dangerous,constant activity,equipment,bright lights,and high fatality rate.The demands placed on nurses to care for critically ill patients in this environment frequently prevent nurses and other health‑care professionals from acknowledging the feelings of patient’s relatives or family caregivers,resulting in a hostile environment from the patient’s relative’s perspective.When a patient’s family enters the ICU,they feel that hospital administrators do little to nothing to alleviate their discomfort and fear.Despite research demonstrating the importance of providing a homely environment for patients’families,In Nigeria ICU is still far behind how a conventional ICU environment should be structured to accommodate patient’s relations in the unit.The goal of this study was to look at the patient’s relative’s perspective on providing care for a critically ill patient in an ICU,with a focus on the unit’s complexity and overall experience.Based on the findings of this study,we recommend that hospital administrators ensure that the environment of the upcoming ICU is designed to meet the needs of patient’s relatives by addressing identified environmental concerns,like caring neglect,by providing a friendly and stress‑free environment.

Hospital-based health technology assessment:The next frontier for traditional Chinese medicine hospitals

Hospital-based health technology assessment(HB-HTA)is highly valuable in the application of hospital medical technology,cost control,improvement of medical quality,and protection of medical safety,and its use is increasing daily globally.However,in China,HB-HTA is still in its infancy,and it is yet to be adopted in traditional Chinese medicine(TCM).Therefore,this article introduces the application and development of HB-HTA,as well as discusses the current situation of TCM and related future development strategies to provide ideas and references for the development of HB-HTA in TCM.We conclude and recommend that all major stakeholders,including the state,health departments,and hospital leaders,support and promote the exploration and development of HB-HTA in TCM hospitals and integrative medicine hospitals.We also suggest the utilization of existing talents and introduction of other necessary talents to promote better and faster organizational development,as well as suggest the formation of a national and internationally recognized HB-HTA guidance manual and toolkit for TCM hospitals based on both the national HTA guidelines and the evaluation of TCM hospitals pilot projects.Moreover,we recommend that HB-HTA pilot study should be executed with Chinese patent medicine as the starting point to form the implementation process and framework in the TCM arena.

Can health technology assessments assist the global campaign against poverty?

Although a key tenant of the Sustainable Development Goals is to achieve universal health coverage,the global drug gap persists-cver a third of the global population lack access to essential medicines.Without access to affordable drugs,people have worse health outcomes,higher medical expenses,and productivity loss,pushing them into poverty.Health technology assessments(HTAs)offer an opportunity to decrease the global drug gap and increase access to essential medicines by overcoming barriers to medicine access.These barriers include drug procurement,drug affordability for payers and patients,a patienfs ability to obtain essential medicines,and health system capacity.Using HTAs can therefore close the global drug gap by increasing access to affordable essential medicines.In turn,people have better health outcomes,spend less money on medical care,and can have better productivity.Ultimately,use of HTAs can lift the population out of poverty and force fewer people into poverty by creating better health outcomes at affordable prices.

Corporate Social Responsibility in Health Technology Industry Prior and during the Covid-19 Pandemic, in Greece

Corporate Social Responsibility (CSR) activities have been revealed as an emerging managerial tool and research field. The socioeconomic impact of the COVID-19 pandemic has prompted several companies to take on CSR initiatives. The objective of this study was to investigate CSR initiatives implemented in companies specializing in pharmaceutical and biomedical products as well as medical equipment, prior and during the COVID-19 pandemic. A cross-sectional study was conducted in companies of the Hellenic Association of Pharmaceutical Companies (SFEE), the Panhellenic Association of Pharmaceutical Industry (PEF) and the Association of Health-Research and Biotechnology Industry (SEIV). A self-administered questionnaire was distributed to a total of 112 companies. Descriptive and multivariate statistical analyses were performed using SPSS 25.0. Levels of significance were two-tailed and statistical significance was set at p = 0.05. The final sample consisted of 74 companies with a response rate of 77.7%. Among them 62.2% were multinational and 37.8% national companies. Some companies provided pharmaceuticals (40.5%), medical equipment and biotechnology products (32.4%) and others were specializing in both categories (27.1%). A percentage equal to 89.2% stated that they implemented CSR activities, out of which 75.7% carried out COVID-19 related initiatives, such as in public health (37.7%), societal issues (27.2%), environment (19.9%), etc. Approximately 50% increased their CSR activities during the pandemic. Moreover, the majority of companies devoted ≤30% of their total CSR budget against the pandemic. The higher a company’s turnover, the higher CSR activities performance. Pharmaceutical and biomedical companies in Greece implemented CSR actions, prior and during the pandemic. Companies contributed to handle the effects of health crisis through CSR Covid-19 related activities, which differentiated according to company’s culture and wealth. It is important that authorities should reward companies carrying out CSR initiatives, given that they positively contribute to the societal recovery by financially supporting the health care sector and the overall economy.

The Impact of Health Information Technology on Hospital Performance: A Systematic Integrative Literature Review

Objective: To review, categorise, and synthesise findings from literature on health information technology (HIT) functionalities, HIT use, and the impact of HIT on hospital performance. Materials and Methods: We conducted a systematic integrative literature review based on a compre-hensive database search. To organise, categorise and synthesise the ex-isting literature, we adopted the affordance actualization theory. To align the literature with our research framework, we used four categories: 1) the functionalities of HIT and how these functionalities are measured;2) use and immediate outcomes of HIT functionalities;3) different perfor-mance indicators and how HIT functionalities affect them;and 4) what hospital characteristics influence the outcome of hospital performance. Results: Fifty-two studies were included. We identified four types of HIT. Only ten studies (19.2%) define the use of HIT by explicitly meas-uring the use rate of HIT. We identified five dimensions of hospital per-formance indicators. Every dimension showed mixed results;however, in general, HIT has a positive impact on mortality and patient readmis-sions. We found several hospital characteristics that may affect the rela-tionship between HIT and hospital-level outcomes. Discussion: Further efforts should focus on embedded research on HIT functionalities, use and effects of HIT implementations with more performance indicators and adjusted for hospital characteristics. Conclusion: The proposed framework could help hospitals and researchers make decisions regard-ing the functionalities, use and effects of HIT implementation in hospi-tals. Given our research outcomes, we suggest future research opportuni-ties to improve understanding of how HIT affects hospital performance. .

Mobile health technology: a novel tool in chronic disease management

The successful control of chronic diseases mainly depends on how well patients manage their disease conditions with the aid of healthcare providers.Mobile health technology—also known as mHealth—supports healthcare practice by means of mobile devices such as smartphone applications,web-based technologies,telecommunications services,social media,and wearable technology,and is becoming increasingly popular.Many studies have evaluated the utility of mHealth as a tool to improve chronic disease management through monitoring and feedback,educational and lifestyle interventions,clinical decision support,medication adherence,risk screening,and rehabilitation support.The aim of this article is to summarize systematic reviews addressing the effect of mHealth on the outcome of patients with chronic diseases.We describe the current applications of various mHealth approaches,evaluate their effectiveness as well as limitations,and discuss potential challenges in their future development.The evidence to date indicates that none of the existing mHealth technologies are inferior to traditional care.Telehealth and web-based technologies are the most frequently reported interventions,with promising results ranging from alleviation of disease-related symptoms,improvement in medication adherence,and decreased rates of rehospitalization and mortality.The new generation of mHealth devices based on various technologies are likely to provide more efficient and personalized healthcare programs for patients.

Hydraulic metal structure health diagnosis based on data mining technology

In conjunction with association rules for data mining, the connections between testing indices and strong and weak association rules were determined, and new derivative rules were obtained by further reasoning. Association rules were used to analyze correlation and check consistency between indices. This study shows that the judgment obtained by weak association rules or non-association rules is more accurate and more credible than that obtained by strong association rules. When the testing grades of two indices in the weak association rules are inconsistent, the testing grades of indices are more likely to be erroneous, and the mistakes are often caused by human factors. Clustering data mining technology was used to analyze the reliability of a diagnosis, or to perform health diagnosis directly. Analysis showed that the clustering results are related to the indices selected, and that if the indices selected are more significant, the characteristics of clustering results are also more significant, and the analysis or diagnosis is more credible. The indices and diagnosis analysis function produced by this study provide a necessary theoretical foundation and new ideas for the development of hydraulic metal structure health diagnosis technology.

The Elder Health Information Technology Framework for Geriatric Care in Rural India: A Policy Initiative

Healthcare monitoring and analysis of healthcare parameters is a reality to reduce costs and increase access to specialist and experts that holds the future for geriatric care in India. This paper proposes distinct methods towards the implementation of rural elder health information technologies (IT), which includes electronic medical records, clinical decision support, mobile medical applications, and software driven medical devices used in the diagnosis or treatment of disease for the older adult population in the villages of India. The purpose is online patient satisfaction at the microlevel (village panchayat) through methods accessible and affordable by establishing a common standard of operations at the village primary care units giving way to early disease detection and routine screening among the aged population avoiding institutionalization. The rural elder health IT framework is of great interest for all stakeholders in the field, as it benefits the investors and the consumers, adding to the technological infrastructure, thereby opening new avenues of research in health informatics, telemedicine and enhancing the scope of geriatric research, which in turn enhances the health-related quality of life for the rural older adults in the remote villages of the nation.

Routine Supportive Supervision and Management of Medicines and Other Health Products and Technologies in Vihiga County, Kenya

Health Products and Technologies (HPTs) are pivotal for an efficient health system. Availability and accessibility to affordable health products are critical indicators towards achieving universal health coverage. Routine supportive supervision, performance monitoring, recognition of efforts and client feedback are vital activities toward health supply chain system strengthening. This is a descriptive paper that describes a model of integrated commodity supportive supervision, and mentorship and its impact on various outcomes of health commodity management. Data were abstracted from the standardized scored checklists used during integrated commodity supportive supervision and supply chain audit in public health facilities in Vihiga County. Scores for the period 2020 to 2022 were analyzed on the eight key areas of interest. The analysis was done using Statistical Package for Social Sciences (SPSS version 26). Results are interpreted at 95% Confidence interval. This paper also shares findings from both quantitative and qualitative data from client exit and facility managers’ interviews. Six complete rounds of supervisions, three clients and service providers’ interviews, and three annual award events have been conducted. We observed trends across six data collections points and compared the results at first point or baseline (January-June 2020) to the results at the last point or end line (April-June 2022). Findings show significant improvements on the eight parameters in terms of mean scores as follows: resolution of issues from previous visits by 35.06% (46.75% - 81.81%);storage of HPTs by 17.41% (68.72% - 86.13%);inventory management by 28.16% (42.67% - 70.83%);availability and use of commodity data management information systems (MIS) tools by 22.39% (74.40% - 96.79%);verification of commodity data by 25.61% (65.56% - 91.17%);availability of guidelines and job aids for commodity management by 46.28% (36.65% - 82.93%). There was an improvement on the mean score on accountability by 20.22% (58.58% - 83.51%). The composite (final) score improved by 28.33% (56.19% - 84.52%). There was progressive narrowing of the standard deviations on all the indicators across the study period. This demonstrates that there is standardization of practices and positive competition among all the public health facilities. There were significant improvements on all the eight indicators. Routine integrated commodity supportive supervision has proven to be an effective high impact intervention in improving management of health products and technologies in Vihiga County, Kenya.

Virtual healthcare services and digital health technologies deployed during coronavirus disease 2019(COVID-19)pandemic in South Africa:a systematic review

Aims:To identify virtual healthcare services and digital health technologies deployed in South Africa during coronavirus disease 2019(COVID-19)and the challenges associated with their use.Metiiods:To determine the status of digital health utilization during COVID-19 in South Africa,the preferred reporting items for systematic reviews and meta-analyses model was used to perform a systematic and in-depth critical analysis of previously published studies in well-known and trusted online electronic databases using specific search keywords words that are relevant to this study.We selected published peer-reviewed articles available from the onset of COVID-19 to July 2021.Results:Total of 24 articles were included into this study.This study revealed that South Africa adopted digital technologies such as SMS-based solutions,mobile health applications,telemedicine and telehealth,WhatsApp-based systems,artificial intelligence and chatbots and robotics to provide healthcare services during COVID-19 pandemic.These innovative technologies have been used for various purposes including screening infectious and non-infectious diseases,disease surveillance and monitoring,medication and treatment compliance,creating awareness and communication.The study also revealed that teleconsultation and e-prescription,telelaboratory and telepharmacy,teleeducation and teletraining,teledermatology,teleradiology,telecardiology,teleophthalmology,teleneurology,telerehabilitation,teleoncology and telepsychiatry are among virtual healthcare services delivered through digital health technologies during COVID-19 in South Africa.However,these smart digital health technologies face several impediments such as infrastructural and technological barriers,organization and financial barriers,policy and regulatory barriers as well as cultural barriers.Conclusion:Although COVID-19 has invigorated the use of digital health technologies,there are still some shortcomings.The outbreak of pandemics like COVID-19 in the future is not inevitable.Therefore,we recommend increasing community networks in rural areas to bridge the digital divide and the modification of mHealth policy to advocate for the effective use of innovative technologies in healthcare and the development of sustainable strategies for resources mobilization through private-public partnerships as well as joining available international initiatives advocating for smart digital health.

三级医疗机构医院卫生技术评估实施现况

目的分析三级医疗机构医院卫生技术(hospital-based health technology assessment,HB-HTA)评估开展现状,为完善医疗机构HB-HTA的应用提供参考和依据。方法运用便利抽样方法,对国家卫生健康委员会医疗管理服务指导中心HB-HTA工作试点医院和已开展HB-HTA的其他医院进行问卷调查和关键知情人访谈。结果共调查19家三级医疗机构,开展HB-HTA有利于促进医疗机构科学管理决策、保障医疗质量和安全、节约医院预算、提高HB-HTA认知水平。但目前HB-HTA还存在缺乏长期持续开展的激励机制、缺乏HB-HTA相关专业人才和部门、HB-HTA流程过于繁杂、卫生技术评估时效性较差、决策支持效率较低、研究结果推广率低等问题。结论建议加强政策、资金支持,注重加强医院内部卫生技术评估人才的引进和能力培训,积极鼓励和引导医院内部建立具体HB-HTA小组或者部门,探索开发HB-HTA支持决策流程的智能化工具或软件,通过多种方式促进评估成果和评估报告的传播共享,不断完善HB-HTA的开展。

含抗菌剂缝线卫生技术评估

目的通过卫生技术评估过程系统评估含抗菌剂缝线的价值,为医疗机构科学采购提供决策依据,为医用耗材科学评估提供参考及建议。方法参考欧洲卫生技术评估网络核心模型及欧洲联盟医院卫生技术评估手册推荐框架,通过文献研究、meta分析、卫生经济学模型测算等方法全面评估含抗菌剂缝线的安全性、有效性、经济性及社会性。结果相比不含抗菌剂缝线,含抗菌剂缝线可在一定程度上降低发生手术部位感染的风险,节省因手术部位感染产生的费用。结合现有证据,含抗菌剂缝线不会产生耐药性,且不会对操作者学习曲线造成影响。结论含抗菌剂缝线能够降低发生手术部位感染的风险,对降低医疗机构整体成本支出有积极影响。手术部位感染控制属于集束化管理,医院感染管控仍需多措并举。医用耗材卫生技术评估存在较大挑战,需开展进一步探索。

生产率损失测量工具的比较研究

目的 比较可用于卫生技术评估中的生产率损失测量工具,厘清可用于卫生技术评估中的生产率损失测量工具的应用条件,以期为相关研究者在选择生产率损失的测量工具时提供参考。方法 检索PubMed、Web of Science、中国知网、万方、维普等中外数据库,检索时间从数据库建库至2021年11月,由2名研究者按照纳入与排除标准独立筛选文献、识别生产率损失测量工具、提取资料。结果 共识别出5种可用于卫生技术评估领域中的生产率损失测量工具,包括工作能力和活动受损量表(work productivity activity and impairment,WPAI)、工作能力局限调查问卷(work limitations questionnaire,WLQ)、健康与工作绩效问卷(Health and Work Performance Questionnaire,HPQ)、损失产能的估值(Valuation of Lost Productivity Questionnaire,VOLP)和医疗技术评估研究院(Institute for Medical Technology Assessment,IMTA)的生产力成本问卷(IMTA Productivity Questionnaire,IPCQ)。其中WPAI和WLQ是测量属性证据最为充足的工具;VOLP是成本涵盖最全的工具;WLQ是数据敏感性最强的工具;IPCQ是货币转化方法最多的工具;WPAI是获取使用最方便的工具。结论 对于卫生技术评估中的生产率损失测量的标准工具尚未存在统一共识,研究者可根据自身研究选取生产率损失测量工具。

Assessment of a Downloadable Application with Avatar Guidance for PT-Prescribed Home Exercise after Total Knee Arthroplasty: A 30-Day Usability and Feasibility Study

Objective: To explore the usability and feasibility of a downloadable application (APP) compared to paper handouts (CONTROL) in guiding 30 days of PT-prescribed home exercise after total knee arthroplasty (TKA), and to compare functional outcomes at 30 days postoperatively between APP and CONTROL. Design: Randomized controlled usability and feasibility study. Setting: Rehabilitation laboratories at two regional medical centers. Participants: Individuals with knee osteoarthritis undergoing unilateral TKA (APP group: N = 26;mean age, 67.0 ± 8.2 y;CONTROL group: N = 31;mean age, 64.7 ± 7.7 y). Interventions: This study assessed the user experience of a downloadable app to guide 30 days of home exercises and instruction after TKA and compared exploratory outcomes to a group using paper handouts. Main Outcome Measures: The System Usability Scale (SUS) score was used to assess patient usability experience. Raw SUS scores were dichotomized (≥72% or <72%) to determine app usability against a 75% a priori criterion for mean APP group score. Feasibility for app use was similarly evaluated in the APP group only through a priori criteria applied to computing device ownership and study use, to the absence of technology-based barriers to participation, and to completion of app-based testing. Exploratory measures compared change from baseline to 30 days for functional and patient-reported outcomes between APP and CONTROL. Results: The APP group’s mean SUS score of 79.2% at 30 days exceeded the 75% threshold for good usability. The app met the predetermined a priori feasibility criteria for absence of technology-based barriers to participation (75% of participants) and completion of app-based testing (91.3% of participants). Personal computing devices were used by 71.4% of APP participants, which was below the 75% a priori feasibility criterion. No differences between the APP and CONTROL groups were observed for functional or patient-reported outcomes. Conclusions: The app-based platform met the a priori criteria for usability for 79% of APP participants. Our findings suggest that app-based, avatar-guided home exercise after TKA has acceptable usability and feasibility. The app-guided patient assessment capability also demonstrates preliminary feasibility for guiding and administering functional and self-reported outcomes assessments.

Knowledge Representation in Patient Safety Reporting: An Ontological Approach

Purpose： The current development of patient safety reporting systems is criticized for loss of information and low data quality due to the lack of a uniformed domain knowledge base and text processing functionality. To improve patient safety reporting, the present paper suggests an ontological representation of patient safety knowledge. Design/methodology/approach： We propose a framework for constructing an ontological knowledge base of patient safety. The present paper describes our design, implementation,and evaluation of the ontology at its initial stage. Findings： We describe the design and initial outcomes of the ontology implementation. The evaluation results demonstrate the clinical validity of the ontology by a self-developed survey measurement. Research limitations： The proposed ontology was developed and evaluated using a small number of information sources. Presently, US data are used, but they are not essential for the ultimate structure of the ontology.Practical implications： The goal of improving patient safety can be aided through investigating patient safety reports and providing actionable knowledge to clinical practitioners.As such, constructing a domain specific ontology for patient safety reports serves as a cornerstone in information collection and text mining methods.Originality/value： The use of ontologies provides abstracted representation of semantic information and enables a wealth of applications in a reporting system. Therefore, constructing such a knowledge base is recognized as a high priority in health care.

The Contribution of Technological Approaches in Reducing Maternal Mortality: An Integrative Review

Aim: To analyze the role of available health technologies and techniques in reducing the number of women dying during pregnancy and childbirth. Background: Health condition of women during pregnancy and childbirth is very sensitive. During this period, proper and timely care plays an important role in reducing maternal mortality. Design: Whitte more and Knal’s framework for integrative reviews was followed in the review. PUBMED/MEDLINE, CINHAL and COCHRANE were searched for published studies between 2008 and 2015. Studies included were systematic reviews, randomized control trials, prospective cohort study, literature review and descriptive studies. Methods: 28 articles were selected to be included in the review. An integrative review approach was followed to analyze data and draw conclusions. Screening of titles and abstracts along with data extraction was completed by two authors independently. Study quality is not reported because of the methodological difficulties. Data synthesis consists of writing descriptive summaries and thematic analysis of the key findings in the included articles. Results: The included studies were based on health technologies and techniques including different devices and tools, medication and drugs, massage techniques, immersion in water, intervention radiology, simulations and training for the health professional. Conclusion: There are numerous health technologies and techniques which are relatively simple to develop, effective to use and safe to apply with no adverse effects. These include simulations and training programs, educational and awareness programs, decision support tools and information systems. Besides these, there are technologies and techniques which show promising results with no or very little adverse effects. These include Active management of the third stage of labour, use of magnesium sulphate, uterine balloon tamponade, wearable cardiac defibrillator and non-pneumatic anti-shock garment. The government, hospitals and care providers should make policies to develop and implement such type of technologies and techniques.

1st UMN-CAS Bilateral Seminar on PM_(2.5) science,health effects and control technology Xi'an,China,May 27-28,2014

The First UMN-CAS Bilateral Seminar was successfully con- cluded with all the goals met. The meeting in Xi＇an was informative, stimulating and enjoyable, thanks to the local host, Prof. Junji Cao, and his capable staff. The Bilateral Seminar was organized by Prof. David Y.H. Pui of the University of Minnesota and Prof. Junji Cao of the Institute of Earth Environment, Chinese Academy of Sci- ences. It was attended by approximately 100 delegates from the University of Minnesota （UMN）, the Center for Filtration Research （CFR）, the Chinese Academy of Sciences （CAS） and other famous Chinese universities. We are grateful for the opening remarks given by UMN President Eric hai Li on behalf of President Kaler and CAS Vice President Jing- Chunli Bai.