Academic literature on the topic 'Medical sciences Electronic information resources'
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Journal articles on the topic "Medical sciences Electronic information resources"
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Harger, Nancy E. "Electronic Resources in Medical Libraries: Issues and Solutions." Journal of the Medical Library Association : JMLA 96, no. 2 (April 2008): 171–72. http://dx.doi.org/10.3163/1536-5050.96.2.172.
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Eskrootchi, Rogheyeh, and Mohammad Ali Boroumand. "Marketing methods for electronic resources in medical libraries: a study on the application of the analytical hierarchy process." Journal of the Medical Library Association 110, no. 3 (December 8, 2022): 332–39. http://dx.doi.org/10.5195/jmla.2022.1351.
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Paired with the high cost of providing access to electronic resources in medical libraries, the inefficient use of these resources highlights the need for more efforts to promote these resources than ever before. In this study, electronic resource marketing methods were prioritized and the best strategies were determined using the analytical hierarchy process (AHP). Using an analytical survey of officials of medical libraries, the most common methods for marketing electronic resources in libraries were determined and divided into categories of strategies. Five important criteria for marketing strategies were also selected. Using AHP, pairwise comparisons were performed between the alternatives (i.e., strategies), which were evaluated against the selected criteria. Data analysis was performed using Expert Choice 11 software. A total of 44 electronic resource marketing methods were identified and categorized into 4 strategies. On average, 43.9% of these methods were used by the surveyed libraries. The AHP showed that simplicity was the most important criterion and that communication networks were the best electronic resource marketing strategy. Home/off-campus access, group training, library search stations, and marketing by individual librarians were the most preferred methods of marketing electronic resources. With the availability of a variety of different methods for marketing electronic resources, medical libraries must select strategies based on important criteria depending on the characteristics of the library, librarians, and users. Thus, the AHP can be an effective and practical solution to decision-making by mathematically prioritizing the selection of the best strategies from a set of alternatives based on differentially weighted criteria.
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Wolverton, Robert E., Karen Davidson, and Shima Moradi. "Electronic resources for health and medical systems in Iran." Journal of Electronic Resources Librarianship 31, no. 1 (January 2, 2019): 41–46. http://dx.doi.org/10.1080/1941126x.2018.1562609.
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Thanuskodi, S. "Use of Internet and Electronic Resources for Medical Science Information: A Case Study." Journal of Communication 1, no. 1 (July 2010): 37–44. http://dx.doi.org/10.1080/0976691x.2010.11884769.
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Preddie, Martha Ingrid. "Clinician-selected Electronic Information Resources do not Guarantee Accuracy in Answering Primary Care Physicians' Information Needs." Evidence Based Library and Information Practice 3, no. 1 (March 17, 2008): 78. http://dx.doi.org/10.18438/b8n011.
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A review of:
McKibbon, K. Ann, and Douglas B. Fridsma. “Effectiveness of Clinician-selected Electronic Information Resources for Answering Primary Care Physicians’ Information Needs.” Journal of the American Medical Informatics Association 13.6 (2006): 653-9.
Objective – To determine if electronic information resources selected by primary care physicians improve their ability to answer simulated clinical questions.
Design – An observational study utilizing hour-long interviews and think-aloud protocols.
Setting – The offices and clinics of primary care physicians in Canada and the United States.
Subjects – 25 primary care physicians of whom 4 were women, 17 were from Canada, 22 were family physicians, and 24 were board certified.
Methods – Participants provided responses to 23 multiple-choice questions. Each physician then chose two questions and looked for the answers utilizing information resources of their own choice. The search processes, chosen resources and search times were noted. These were analyzed along with data on the accuracy of the answers and certainties related to the answer to each clinical question prior to the search.
Main results – Twenty-three physicians sought answers to 46 simulated clinical questions. Utilizing only electronic information resources, physicians spent a mean of 13.0 (SD 5.5) minutes searching for answers to the questions, an average of 7.3 (SD 4.0) minutes for the first question and 5.8 (SD 2.2) minutes to answer the second question. On average, 1.8 resources were utilized per question. Resources that summarized information, such as the Cochrane Database of Systematic Reviews, UpToDate and Clinical Evidence, were favored 39.2% of the time, MEDLINE (Ovid and PubMed) 35.7%, and Internet resources including Google 22.6%. Almost 50% of the search and retrieval strategies were keyword-based, while MeSH, subheadings and limiting were used less frequently. On average, before searching physicians answered 10 of 23 (43.5%) questions accurately. For questions that were searched using clinician-selected electronic resources, 18 (39.1%) of the 46 answers were accurate before searching, while 19 (42.1%) were accurate after searching. The difference of one correct answer was due to the answers from 5 (10.9%) questions changing from correct to incorrect, while the answers to 6 questions (13.0%) changed from incorrect to correct. The ability to provide correct answers differed among the various resources. Google and Cochrane provided the correct answers about 50% of the time while PubMed, Ovid MEDLINE, UpToDate, Ovid Evidence Based Medicine Reviews and InfoPOEMs were more likely to be associated with incorrect answers. Physicians also seemed unable to determine when they needed to search for information in order to make an accurate decision.
Conclusion – Clinician-selected electronic information resources did not guarantee accuracy in the answers provided to simulated clinical questions. At times the use of these resources caused physicians to change self-determined correct answers to incorrect ones. The authors state that this was possibly due to factors such as poor choice of resources, ineffective search strategies, time constraints and automation bias. Library and information practitioners have an important role to play in identifying and advocating for appropriate information resources to be integrated into the electronic medical record systems provided by health care institutions to ensure evidence based health care delivery.
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Porumbeanu, Octavia-Luciana. "The impact of electronic resources and new technology in academic medical libraries in Romania." Health Information & Libraries Journal 26, no. 2 (May 27, 2009): 151–55. http://dx.doi.org/10.1111/j.1471-1842.2009.00845.x.
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Lakshanakumar, B. M., and K. Senthilnayagam. "Use of Electronic Resources by the Faculty Members of Government Medical College Libraries in Karnataka." Indian Journal of Information Sources and Services 9, no. 2 (May 5, 2019): 102–5. http://dx.doi.org/10.51983/ijiss.2019.9.2.614.
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Medical college libraries are aiming to provide efficient information services using both electronic and printed scholarly information resources to the medical professionals This paper study on the use of E-resources (e-books, e-journals, e-databases) subscribed by Health Science Library and Information Network, HELINET Consortium. The study sample is the faculty members of Government Medical Colleges. The study found that use of E Resources and use of Database by faculty members is not up to expectation of the provider and the investment.
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Bauer, Kathleen. "Indexes as Tools for Measuring Usage of Print and Electronic Resources." College & Research Libraries 62, no. 1 (January 1, 2001): 36–42. http://dx.doi.org/10.5860/crl.62.1.36.
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Libraries are experiencing rapid change as they add electronic resources. These resources are popular with patrons, but their usage is not captured in traditional library statistics. Libraries must find a way to represent the diverse data available for electronic resources in some meaningful way that allows for comparison with statistics for print resources. To do this, the Cushing/Whitney Medical Library has created two indexes, the Electronic and Print Usage Indexes. An index is a simple tool that combines data on items from a group into one number and so represents overall change in the group. The indexes at Cushing/Whitney show that in 1998–1999, patron usage of electronic resources more than doubled, whereas print use declined.
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Felber, Sue H. "The Medical Library Association Guide to Cancer Information: Authoritative, Patient-Friendly Print, and Electronic Resources." Journal of the Medical Library Association : JMLA 96, no. 2 (April 2008): 172–73. http://dx.doi.org/10.3163/1536-5050.96.2.173.
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Boumarafi, Behdja. "Electronic Resources at the University of Sharjah Medical Library: An Investigation of Students' Information-Seeking Behavior." Medical Reference Services Quarterly 29, no. 4 (October 29, 2010): 349–62. http://dx.doi.org/10.1080/02763869.2010.518921.
Full textDissertations / Theses on the topic "Medical sciences Electronic information resources"
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Ramadan, Jemal Saleh, and Niclas Södermark. "Development of an Electronic Medical Record System." Thesis, KTH, Skolan för informations- och kommunikationsteknik (ICT), 2014. http://urn.kb.se/resolve?urn=urn:nbn:se:kth:diva-177008.
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Sofiaängen (http://sofiaangen.com/) är en psykoterapeutisk dagverksamhet och skola som ligger på Södermalm i Stockholm. Sofiaängen riktar sig till ungdomar i åldern 14 till 20 med psykiska och sociala problem. Det nuvarande systemet som används av Sofiaängen för att hantera patientjournaler är i form av textfiler placerade i en delad mapp på en Mac-server, vilketvarken är strukturerat, effektivt eller flexibelt. Syftet med detta examensarbete har därför varit att hitta det bästa sättet att implementera ett journalsystem för patientjournaler på, samt att utforma, utveckla och driftsätta den valda lösningen. Arbetet delades in i fyra olika faser. Under den första fasen genomfördes en förstudie där möjliga implementeringar (fristående eller webbaserad) studerades och resultatet överlämnades till beställaren som fick välja den mest lämpliga lösningen. De tre övriga faserna var att utforma, genomföra (och testa) och distribuera den valda lösningen, samt att skriva en användarmanual. Den valda lösningen, att skapa systemet som ett fristående program, implementerades med JavaFX:s plattform och MySQL:s databas-server. Vi använde en iterativ arbetsprocess för att stegvis utveckla de funktionella kraven. Detta för att kunna utvärdera vårt arbete tidigt, utifrån feedback på utvecklingen från beställaren, innan nästa uppsättning krav genomfördes. Examensarbetet har resulterat iett journalsystem som uppfyller alla krav på funktionalitet och design av användargränssnittet som krävdes av Sofiaängen.Sofiaängen (http://sofiaangen.com/)is a psychotherapeutic day activities center and school located in Södermalm in Stockholm. Sofiaängen targets young peo-ple between the age of 14 and 20 and who have psychological orsocial prob-lems. The current system used by Sofiaängen for handling patient medical records is a Microsoft word file-system on a Mac server, which is neitherefficient norflex-ible. The objective of this bachelor thesis has therefore been to find the best way of implementing an EMRS as well asdesigning, developingand deployingthe selected solution. The work was divided into four different phases. The first phase was conduct-ing feasibility study where possible implementations (standalone and web based) were studied. The result was submitted to Sofiaängen so they couldmake a selection. The second,third and fourth phases were respectively de-signing, implementing (and testing) and deploying the selected solution. The selected solution was to implement the system as a standalone application. The system was implemented using the JavaFX platform andaMySQL data-base server. We used an iterative software developmentmodel in order to implement the functional requirements incrementally andin doing so we were able to evaluate our work early, before the next set of requirements were implemented after get-tingfeedback on the development from Sofiaängen. The Degree project has resulted in an EMRS which fulfills all of the functional and look-and-feel requirements required by Sofiaängen.
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Chimwaza, Gracian. "Factors affecting the use and non-use of electronic information resources in scientific technological and medical disciplines at universities in Zimbabwe." Thesis, University of Pretoria, 2017. http://hdl.handle.net/2263/62812.
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The purpose of this study was to investigate factors affecting the use and non-use of free and low-cost library electronic information resources by information specialists (librarians charged with e-resource responsibilities), academic staff and postgraduate students in scientific, technological and medical (STM) disciplines at universities in Zimbabwe. The research problem was: What are the factors affecting the use and non-use of e-resources by information specialists, academic staff and postgraduate students in scientific, technological and medical (STM) disciplines at universities in Zimbabwe? To address this problem, several sub-questions were set, covering the situation of free and low-cost e-resources available to Zimbabwean universities, factors influencing access to e-resources, the actual use of such resources, and how these problems should be addressed. The study also considered reports from related studies. Using convenience and purposive sampling depending on the participant group, empirical data were collected from information specialists, academic staff and post-graduate students from five universities in Zimbabwe (Africa University, Chinhoyi University of Technology, Midlands State University, National University of Science and Technology and University of Zimbabwe) from May to July 2015. Quantitative and limited qualitative data were collected through questionnaires administered to library directors, information specialists, academic staff and post-graduate students in the STM disciplines. Four library directors or their representatives, 38 information specialists, 80 academic staff, 121 master’s and 14 doctoral students were involved in the study. Descriptive statistical data on all four groups and inferential statistical data on information specialists, academic staff and postgraduate students are provided. Content analysis was applied to qualitative data to reveal views on factors affecting the use of e-resources. The universities provide access to scholarly literature through large collections of e-resources by means of various databases, e-books and electronic theses and dissertations. The availability of journals is no longer a principal problem; the challenge is how to ensure that what is available can be accessed and is used to best effect. Access to computers is also not a problem, especially for information specialists. There are, however, problems with internet infrastructure (i.e. slow and/or unreliable internet, shortage of internet bandwidth), limited user skills and limited user awareness of available library e-resources. Inferential statistical data analysis determined that the position of the information specialist, whether junior or senior, has an important impact on their use of e-resources. Juniors tended to use e-resources more often than seniors. Good technical support when encountering problems with e-resources had the most significant influence on downloading of full-text articles by information specialists. The general linear model test identified lack of skills in using the e-resources as the factor with the highest significance, compared to other variables that had an effect on the use of e-resources by academic staff in STM disciplines. Of the seven significant variables that affected the frequency with which academic staff downloaded full-text articles, the factor of academic staff duties involving research and supervision of students had the highest significance value. On testing factors influencing postgraduate students’ frequency of using e-resources and their frequency of downloading full-text articles, postgraduate students’ training on Google Scholar was established to have the highest significance regarding both. Recommendations include: improved investment in user skills training and information literacy; tools to improve the discoverability of e-resources and content provided by libraries; effective marketing strategies to improve the use and uptake of e-resources by academic staff and students; ensuring that content covered by e-resources is relevant and up to date; providing technical support to e-resource users when they encounter problems; and ensuring adequate IT and internet infrastructure.Thesis (PhD)--University of Pretoria, 2017.
Information Science
PhD
Unrestricted
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Richardson, Tony Andrew. "Meeting Meaningful-Use Requirements With Electronic Medical Records in a Community Health Clinic." ScholarWorks, 2016. https://scholarworks.waldenu.edu/dissertations/2872.
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Small nonprofit medical practices lack the technical expertise to implement electronic medical records (EMRs) that are consistent with federal meaningful-use requirements. Failure to comply with meaningful-use EMR requirements affects nonprofit community health care leaders' ability to receive reimbursement for care. Complexity theory was the conceptual framework used in this exploratory single case study. The purpose of the study was to explore the strategies nonprofit community health care leaders in Washington, DC used to implement EMRs in order to comply with the meaningful-use requirements. Data were collected via in-depth interviews with 7 purposively-selected health care leaders in a nonprofit clinic and were supplemented with archival records from the organization's policies and legislated mandates. Participants' responses were coded into invariant constituents, single concepts, and ideas to develop theme clusters. Member checking was used to validate the transcribed data which was subsequently coded into 4 themes that included: access to information, quality of care, training, and reporting implications. Recommendations include increased effectiveness of training provided to health care leaders or the perceptions of the patients as stakeholders in EMR implementation. By using strategies that facilitate seamless movement of information within a digital health care infrastructure, business leaders could benefit from improved reimbursement for services. Implications for social change include progress and transformation in the way health care access is provided.
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Hopes, David. "Being objective : communities of practice and the use of cultural artefacts in digital learning environments." Thesis, University of Birmingham, 2014. http://etheses.bham.ac.uk//id/eprint/5344/.
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Over the past decade there has been a dramatic increase in the volume of digital content created from museum, library and archive collections but research on how this material is actually used, particularly in digital learning environments, has fallen far behind the rate of supply. In order to address this gap, this thesis examines how communities of practice (CoPs) involved in the supply and use of digital artefacts in the Higher Education sector in the UK interact with content and what factors affect this process. It focuses on a case study involving the digitisation of Shakespeare collections used in postgraduate research, and the testing of use in a range of different learning environments. This produced a number of significant findings with implications for the HE and cultural sectors. Firstly, similar patterns of artefact use were found across all users suggesting there are generic ways in which everyone interacts with digital artefacts. However, distinct forms of use did emerge which correspond with membership of particular communities of practice. Secondly, members of a CoP appear to share a particular learning style and this is influenced by the learning environment. Finally, the research indicates that a mixed method for analysing and measuring use, piloted and tested in the case study, is possible.
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Diana, Mark L. "Information Technology Outsourcing in U.S. Hospital Systems." VCU Scholars Compass, 2006. https://scholarscompass.vcu.edu/etd/1093.
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The purpose of this study was to determine the factors associated with outsourcing of information systems (IS), and if there is a difference in IS sourcing based on the strategic value of the outsourced functions. The theoretical framework is based upon a synthesis of strategic management theory (SMT) and transaction cost economics (TCE) as they apply to vertical integration in the health care sector; therefore, IS sourcing behavior was conceptualized as a case of vertical integration. The conceptual model proposed that sourcing behavior would be determined by asset specificity, uncertainty, the interaction of asset specificity and uncertainty, bargaining power, corporate strategy needs, and the strategic value of the IS functions outsourced.A cross sectional design was used, consisting of data from the American Hospital Association (AHA), the Area Resource File (ARF), the HIMSS Analytics database, and the Centers for Medicare and Medicaid Services (CMS) hospital cost reports for 2003. The final sample consisted of 1,365 health care delivery systems and 3,452 hospitals. Analysis was conducted using a two-stage negative binomial regression model (using instrumental variables) to correct for suspected endogeneity. Tests of joint restrictions using the group of variables derived from TCE and SMT, respectively, were done with the dependent variable divided between strategic and non-strategic IS functions (the division was done based on a model of Core IS Capabilities developed as a model for a high-performance IS function).The results supported the relationship between bargaining power and IS outsourcing. Results for asset specificity and corporate strategy needs were significant in the opposite direction than hypothesized. No other findings were significant. These results suggest that hospital system managers are likely not considering significant factors when making sourcing decisions, including the relative strategic value of the functions they are outsourcing. This study contributes to the limited body of knowledge surrounding IS sourcing behavior in the health care sector. Future research should examine the effect of cost on IS sourcing decisions, and consider the use of alternative theoretical frameworks, particularly Institutional Theory.
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Li, Fu Min. "Collecting web data for social science research." Thesis, University of Macau, 2018. http://umaclib3.umac.mo/record=b3953492.
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Ugurbas, Suat Hayri. "Evaluation Of An Electronic Medical Record System: Zonguldak Karaelmas University Hospital Survey." Master's thesis, METU, 2006. http://etd.lib.metu.edu.tr/upload/12608125/index.pdf.
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The present study investigated the electronic medical record system (EMR) of Zonguldak Karaelmas University Hospital which is used for six years now. The advantages and disadvantages of an EMR system in comparison with paper
medical records were evaluated based on the user’
s opinion. The recommendations for the development of EMR and more efficient use of the system are principle goals of this study. The purposes of this thesis include promoting the implantation of EMR by introducing the advantages and disadvantages from the user&
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s point of view. The main source of information used in this analysis is gathered from a questionnaire. Hundred and twenty six users of EMR selected voluntarily and randomly from the hospital staffs are included in this survey. The hospital staffs including physicians, nurses, clinicians, administrative clerks and technicians were included in this survey. Implementation for certain medical tasks and efficiency of using these tasks in EMR are evaluated. The advantages and disadvantages of the system were surveyed from the user'
s point of view. In spite of the fact that health care professionals understand the benefits of electronic medical records, barriers to the use of EMR are also important for the current impediments in EMR introduction. While the successful applications of EMR systems are evident in western word, the implementation of EMR to a hospital information system is a new topic in Turkey. There are mainly attempts to convert the paper-based medical record systems to the fully automated electronic record systems. Our study is a pioneering attempt to analyze the users&
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opinion for a fully integrated EMR system in a Turkish academic hospital. The suggestions such as restricting the the access, improving the hardware, integrating to the internet are made for the improvement of the system in future.
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Liu, Hanjun. "Financial incentives and the type of specialty practices impact on the physician use of electronic medical records." Thesis, California State University, Long Beach, 2014. http://pqdtopen.proquest.com/#viewpdf?dispub=1527725.
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Electronic Medical Records (EMRs) are increasingly being used in healthcare organizations. However, there are few factors influencing the physician adoption rate of EMRs. The purpose of this paper is to investigate the meaningful use incentives, and the type of specialty practices in relationship to the physician use of EMRs. Data from the National Ambulatory Medical Care Survey (NAMCS) were analyzed to how meaningful use incentives and the type of physician practices affect the physician use of EMRs. The Chi-Square test and ANOVA test have been use to examine the hypothesis, and the association was found to be statistically significant.
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Bui, Thai Le Quy. "Using Spammers' Computing Resources for Volunteer Computing." PDXScholar, 2014. https://pdxscholar.library.pdx.edu/open_access_etds/1629.
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Spammers are continually looking to circumvent counter-measures seeking to slow them down. An immense amount of time and money is currently devoted to hiding spam, but not enough is devoted to effectively preventing it. One approach for preventing spam is to force the spammer's machine to solve a computational problem of varying difficulty before granting access. The idea is that suspicious or problematic requests are given difficult problems to solve while legitimate requests are allowed through with minimal computation. Unfortunately, most systems that employ this model waste the computing resources being used, as they are directed towards solving cryptographic problems that provide no societal benefit. While systems such as reCAPTCHA and FoldIt have allowed users to contribute solutions to useful problems interactively, an analogous solution for non-interactive proof-of-work does not exist. Towards this end, this paper describes MetaCAPTCHA and reBOINC, an infrastructure for supporting useful proof-of-work that is integrated into a web spam throttling service. The infrastructure dynamically issues CAPTCHAs and proof-of-work puzzles while ensuring that malicious users solve challenging puzzles. Additionally, it provides a framework that enables the computational resources of spammers to be redirected towards meaningful research. To validate the efficacy of our approach, prototype implementations based on OpenCV and BOINC are described that demonstrate the ability to harvest spammer's resources for beneficial purposes.
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Bazile, Emmanuel Patrick. "Electronic Medical Records (EMR): An Empirical Testing of Factors Contributing to Healthcare Professionals’ Resistance to Use EMR Systems." NSUWorks, 2016. http://nsuworks.nova.edu/gscis_etd/964.
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The benefits of using electronic medical records (EMRs) have been well documented; however, despite numerous financial benefits and cost reductions being offered by the federal government, some healthcare professionals have been reluctant to implement EMR systems. In fact, prior research provides evidence of failed EMR implementations due to resistance on the part of physicians, nurses, and clinical administrators. In 2010, only 25% of office-based physicians have basic EMR systems and only 10% have fully functional systems. One of the hindrances believed to be responsible for the slow implementation rates of EMR systems is resistance from healthcare professionals not truly convinced that the system could be of substantive use to them.
This study used quantitative methods to measure the relationships between six constructs, namely computer self-efficacy (CSE), perceived complexity (PC), attitude toward EMR (ATE), peer pressure (PP), anxiety (AXY), and resistance to use of technology (RES), are predominantly found in the literature with mixed results. Moreover, they may play a significant role in exposing the source of resistance that exists amongst American healthcare professionals when using Electronic Medical Records (EMR) Systems. This study also measured four covariates: age, role in healthcare, years in healthcare, gender, and years of computer use. This study used Structural Equation Modeling (SEM) and an analysis of covariance (ANCOVA) to address the research hypotheses proposed. The survey instrument was based on existing construct measures that have been previously validated in literature, however, not in a single model. Thus, construct validity and reliability was done with the help of subject matter experts (SMEs) using the Delphi method. Moreover, a pilot study of 20 participants was conducted before the full data collection was done, where some minor adjustments to the instrument were made. The analysis consisted of SEM using the R software and programming language.
A Web-based survey instrument consisting of 45 items was used to assess the six constructs and demographics data. The data was collected from healthcare professionals across the United States. After data cleaning, 258 responses were found to be viable for further analysis. Resistance to EMR Systems amongst healthcare professionals was examined through the utilization of a quantitative methodology and a cross-sectional research measuring the self-report survey responses of medical professionals. The analysis found that the overall R2 after the SEM was performed, the model had an overall R2 of 0.78, which indicated that 78% variability in RES could be accounted by CSE, PC, ATE, PP, and AXY. The SEM analysis of AXY and RES illustrated a path that was highly significant (β= 0.87, p < .001), while the other constructs impact on RES were not significant. No covariates, besides years of computer use, were found to show any significance differences.
This research study has numerous implications for practice and research. The identification of significant predictors of resistance can assist healthcare administrators and EMR system vendors to develop ways to improve the design of the system. This study results also help identify other aspects of EMR system implementation and use that will reduce resistance by healthcare professionals. From a research perspective, the identification of specific attitudinal, demographic, professional, or knowledge-related predictors of reference through the SEM and ANCOVA could provide future researchers with an indication of where to focus additional research attention in order to obtain more precise knowledge about the roots of physician resistance to using EMR systems.
Books on the topic "Medical sciences Electronic information resources"
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Conference, Special Libraries Association. Locally mounted electronic products in biomedical and life sciences libraries: Proceedings of the Contributed Papers Session, Biological Sciences Division, Special Libraries Association, 87th Annual Conference, June 12, 1996. [U.S.A.]: The Association, 1996.
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Meeting the need for inter-operability and information security in health IT: Hearing before the Committee on Science and Technology, House of Representatives, One Hundred Tenth Congress, first session, September 26, 2007. Washington: U.S. G.P.O., 2008.
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Louis, Rosenfeld. The Internet compendium: Subject guides to social sciences, business and law resources. London: Mansell, 1995.
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Louis, Rosenfeld. The Internet compendium: Subject guides to humanities resources. London: Mansell, 1995.
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Louis, Rosenfeld. The Internet compendium: Subject guides to health and science resources. London: Mansell, 1995.
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Joseph, Janes, and Vander Kolk Martha, eds. The internet compendium: Subject guides to social sciences, business, and law resources. New York: Neal-Schuman Publishers, 1995.
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Pool, Robert. Bioinformatics: Converting data to knowledge : a workshop summary. Washington, D.C: National Academy Press, 2000.
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Joseph, Janes, and Vander Kolk Martha, eds. The Internet compendium: Subject guides to health and science resources. New York: Neal-Schuman Publishers, 1995.
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Martin, Szomszor, Fowler David, and SpringerLink (Online service), eds. Electronic Healthcare: 4th International Conference, eHealth 2011, Málaga, Spain, November 21-23, 2011, Revised Selected Papers. Berlin, Heidelberg: Springer Berlin Heidelberg, 2012.
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Lee, Hancock, ed. Key guide to electronic resources. Medford, NJ: Learned Information, 1995.
Find full textBook chapters on the topic "Medical sciences Electronic information resources"
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Lotsberg, Maria Lie, and Stacey Ann D’mello Peters. "Publication Bias in Precision Oncology and Cancer Biomarker Research; Challenges and Possible Implications." In Human Perspectives in Health Sciences and Technology, 155–74. Cham: Springer International Publishing, 2022. http://dx.doi.org/10.1007/978-3-030-92612-0_10.
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AbstractPublication bias and lack of information sharing are major obstacles in scientific research. Indeed, a lot of time, money and effort might be misspent on research that has already been undertaken, but not published. Over time, this causes a bias in the scientific literature that has implications for researchers designing new research projects or interpreting results. It also affects society and decision-making processes as important scientific knowledge is not shared, used, and critically discussed. In the specific context of medical research, publication bias can have a great impact on patients’ lives, as they could potentially have received a more adequate treatment or avoided harmful side-effects. The issue of publication bias seems even more stringent for precision oncology and biomarker research, as aiming for perfection or ‘hyper precision’ will leave even less space for ‘negative’ results than in medical research in general. Indeed, although a lot of resources are spent on cancer biomarker research, still only a few biomarkers end up in the clinic, and even for those that “succeed” in this process, there are still challenges with defining cut-offs for biomarker positive and negative subgroups as well as deciding how to treat the biomarker defined subgroups in a most optimal way. The aim of this chapter is to explore the extent of publication bias in the context of precision oncology and cancer biomarker research: its implications on researchers, patients, and society, as well as to reflect on the deeper roots of the problem.
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Crisóstomo-Acevedo, María José, and José Aurelio Medina-Garrido. "Telemedicine Barriers." In Encyclopedia of Human Resources Information Systems, 830–35. IGI Global, 2009. http://dx.doi.org/10.4018/978-1-59904-883-3.ch122.
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Telemedicine implies that there is an exchange of information, without personal contact, between two physicians or between a physician and a patient. Thanks to telecommunications technologies telemedicine enables the provision of healthcare services or the exchange of healthcare information across geographic, temporal, social, and cultural barriers (Chau & Hu, 2004). Through telemedicine, healthcare centers can offer diverse specialty services to other centers, to other physicians, or directly to the patient, such as for example telecardiology, teledermatology, teleendoscopy, telemedicine, telemonitoring, telenursing, telepathology, teleradiology, or telesurgery (Tachakra, 2003). Telemedicine should not be confused with e-health (or teleHealth). Telemedicine only refers to the provision of medical services (Chau & Hu, 2004). E-health, on the other hand, refers both to medical services and to any other type of service, as long as it has something to do with health and employs information technology (Eysenbach, 2001; Rodger & Pendharkar, 2000). In this respect, e-health would also include healthcare educational activities, research in the health sciences, the handling of electronic files in the healthcare system, and any other use of information technologies in the healthcare system. Telemedicine requires a new type of worker: the healthcare teleworker. But unlike in other types of telework, the human factor is much more important for the success of projects in telemedicine. Nevertheless, physicians remain wary of adopting telemedicine. This work examines the sources of the resistance to incorporate telemedicine. It adopts a focus centering on the difficulties that human factors have in accepting the practice of telemedicine.
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Kwon, Maria Vee. "Strategic Approach to 24/7 Services." In Advances in Library and Information Science, 242–50. IGI Global, 2013. http://dx.doi.org/10.4018/978-1-4666-2500-6.ch020.
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This chapter will provide a strategic approach and firsthand insight into the best practices for Nyack Hospital’s User Community “Gateway to NH Medical Library Resources” Virtual Library 24/7 service. In an effort to maximize Library and Information Services (LIS) while minimizing the department’s planned budget and licensing fees, the author will share current practices of the knowledge-based information needs of the Hospital: Nyack Hospital and LIS Mission/Goals/Objectives, US Federal Government Mandates for Electronic Medical Records (EMR), Nyack’s McKesson Paragon Hospital Information System, Coordination of Knowledge Management – eResources (Web-version) and the function of hard copy, Acquisition, Annual Licensing Agreement (Institutional), Dissemination, and Preservation of Information Resources, Coordination with Southeastern New York Library Research Council (SENYLRC) and Hospital Library Program Services (HLSP), Extensive Literature Search and Document Delivery Services thru NLM/DOCLINE and ILL, End-User Orientation and Training, Continuing Medical Education (CME) Services. The author will present the current status of the state-of-the-art Med Lib Research Info Center and conclude with the future direction of the Research Learning Center.
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Ziminski, Timoteus B., Steven A. Demurjian, Eugene Sanzi, Mohammed S. Baihan, and Thomas Agresta. "An Architectural Solution for Health Information Exchange." In Virtual and Mobile Healthcare, 283–327. IGI Global, 2020. http://dx.doi.org/10.4018/978-1-5225-9863-3.ch014.
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Health information technology (HIT) systems including electronic health records (EHRs) have a market saturation nearing 92% at individual institutions but are still unsuited for cross-institutional collaboration of stakeholders (e.g., medical providers such as physicians, hospitals, clinics, labs, etc.) in support of health information exchange (HIE) of different HIT systems in geographically separate locations. In the computer science field, software architectures such as service-oriented architecture, grid computing, publish/subscribe paradigm, and data warehousing are well-established approaches for interoperation. However, the application of these software architectures to support HIE has not been significantly explored. To address this issue, this paper proposes an architectural solution for HIE that leverages established software architectural styles in conjunction with the emergent HL7 standard Fast Healthcare Interoperability Resources (FHIR). FHIR models healthcare data with XML or JSON schemas using a set of 93 resources to track a patient's clinical findings, problems, allergies, adverse events, history, suggested physician orders, care planning, etc. For each resource, a FHIR CRUD RESTful Application Program Interface (API) is defined to share data in a common format for each of the HITs that can then be easily accessible by mobile applications. This paper details an architectural solution for HIE using software architectural styles in conjunction with FHIR to allow HIT systems of stakeholders to be integrated to facilitate collaboration among medical providers. To demonstrate the feasibility and utility of HHIEA, a realistic regional healthcare scenario is introduced that illustrates the interactions of stakeholders across an integrated collection of HIT systems.
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Sass, Julian, Susanne Zabka, Andrea Essenwanger, Josef Schepers, Martin Boeker, and Sylvia Thun. "Fast Healthcare Interoperability Resources (FHIR®) Representation of Medication Data Derived from German Procedure Classification Codes (OPS) Using Identification of Medicinal Products (IDMP) Compliant Terminology." In German Medical Data Sciences: Bringing Data to Life. IOS Press, 2021. http://dx.doi.org/10.3233/shti210074.
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Electronic documentation of medication data is one of the biggest challenges associated with digital clinical documentation. Despite its importance, it has not been consistently implemented in German university hospitals. In this paper we describe the approach of the German Medical Informatics Initiative (MII) towards the modelling of a medication core dataset using FHIR® profiles and standard-compliant terminologies. The FHIR profiles for Medication and MedicationStatement were adapted to the core dataset of the MIl. The terminologies to be used were selected based on the criteria of the ISO-standard for the Identification of Medicinal Products (IDMP). For a first use case with a minimal medication dataset, the entries in the medication chapter of the German Procedure Classification (OPS codes) were analyzed and mapped to IDMP-compliant medication terminology. OPS data are available at all German hospitals as they are mandatory for reimbursement purposes. Reimbursement-relevant encounter data containing OPS medication procedures were used to create a FHIR representation based on the FHIR profiles MedicationStatement and Medication. This minimal solution includes – besides the details on patient and start-/end-dates – the active ingredients identified by the IDMP-compliant codes and – if specified in the OPS code – the route of administration and the range of the amount of substance administered to the patient, using the appropriate unit of measurement code. With FHIR, the medication data can be represented in the data integration centers of the MII to provide a standardized format for data analysis across the MII sites.
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"Utilizing Electronic Communication and Information Resources." In Precepting Medical Residents in the Office, 96–98. CRC Press, 2018. http://dx.doi.org/10.1201/9781315378305-28.
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Abdala, C. Verônica, and Rosane Taruhn. "Access to Health Information in Latin America and the Caribbean." In Electronic Resources in Medical Libraries, 41–50. Routledge, 2021. http://dx.doi.org/10.4324/9780203051948-5.
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"Plagiarism of Print and Electronic Resources." In Encyclopedia of Library and Information Sciences, Third Edition, 4206–15. CRC Press, 2009. http://dx.doi.org/10.1081/e-elis3-120044510.
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Jain, Vinita. "Evaluation of E-Resources in Government." In Advances in Library and Information Science, 16–38. IGI Global, 2013. http://dx.doi.org/10.4018/978-1-4666-4070-2.ch002.
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Throughout history, man has been recording, presenting, and preserving information through various media like palm leaves stores, tablets, leather, clay, etc. The invention of paper and the printing press brought a revolution in this direction. Subsequently, micro documents and audio-video cassettes also arrived on the scene. The 20th century witnessed a revolution in the form of computer for storing and retrieving information. CD-ROM brought a revolution in information storage and retrieval. DVD, with much higher storage capacity, further revolutionized the information delivery mechanism. World Wide Web converted the whole world into an information city. The information going electronic, knowledge storage and retrieval has become dynamic with the help of powerful retrieval engines irrespective of the storage media used, be it CD or Internet. Slowly, the static and paper-based libraries are being replaced by dynamic electronic/digital/virtual mechanisms for producing, organizing, locating, repackaging, and accessing the information. Many libraries have gained experience in developing and building digital resources and their management. Electronic book is a text, analogous to a book that is in digital form to be displayed on a computer screen. E-books are online or in CD-ROMs, which store vast amounts of data in text form, as well as digital images, animation, music, and other sounds to supplement this text.
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Kirtley, Shona. "Electronic Information Sources for Women's Health Knowledge for Professionals." In Medical Informatics in Obstetrics and Gynecology, 278–301. IGI Global, 2009. http://dx.doi.org/10.4018/978-1-60566-078-3.ch014.
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In an age where health professionals lead very busy working lives, electronic information sources provide ease of access to vast amounts of health information on an unprecedented scale. Health professionals have the ability to access the information they require from a location convenient to them and can do so at any time, day or night. This convenience has resulted in an increasing reliance upon electronic sources of information amongst women’s health professionals. As technologies develop, both the importance placed on the electronic dissemination of information by women’s health professionals and the use of such resources will increase dramatically. This chapter outlines the different sources of electronic information available to women’s health professionals, the constantly evolving online accessibility issues, the importance of critical appraisal when assessing the validity of online resources, and the role of the information specialist in the health sector. As this topic is currently under-researched a number of future research directions are also proposed.
Conference papers on the topic "Medical sciences Electronic information resources"
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Emelyanova, N. M. "LIBRARY RESOURCES AND SERVICES IN THE EDUCATIONAL ACTIVITY OF THE UNIVERSITY." In Dynamics of library and information support for education, science and culture. Omsk State Technical University, 2022. http://dx.doi.org/10.25206/978-5-8149-3568-7-2022-38-42.
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The article reveals the use of resources and services of the library by the Scientific Library of the Chita State Medical Academy in the educational process of the university. QR libraries provide secure user access to full-text electronic resources of the Chita State Medical Academy. Mobile access contributes to the promotion of the scientific heritage of the university in the scientific and educational environment.
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Kolbekhina, G. M., M. N. Fast, and N. A. Baryshnikova. "ACTUAL FORMS OF MASS EVENTS OF THE UNIVERSITY LIBRARY IN THE ONLINE MODE (ON THE EXAMPLE OF THE NATIONAL LIBRARY OF THE CHITA STATE MEDICAL ACADEMY)." In Dynamics of library and information support for education, science and culture. Omsk State Technical University, 2022. http://dx.doi.org/10.25206/978-5-8149-3568-7-2022-43-48.
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The article presents the experience of the CHMA scientific library in organizing mass events in an online format. The emphasis is placed on organizing work in the VKontakte social group and conducting remote classes for teachers and residents on the use of electronic library resources. It is concluded that the remote format of mass events remains in demand today. The positive result of using this mode in the library is noted.
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Shrayberg, Yakov L. "Electronic Library: Yesterday, today and tomorrow." In Third scientific and practical conference «BiblioPiter-2022». Russian National Public Library for Science and Technology, 2022. http://dx.doi.org/10.33186/978-5-85638-249-4-80-84.
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The evolution of e-libraries (EL) is reviewed. Several definitions of the term e-library are examined. The core EL function is to build collection of arbitrarily located documents on various media. The differences between ELs and collections of digital resources are analyzed. EL types are listed. Russian electronic library systems (ELS) are characterized. The national electronic libraries (NEL) and open information archives are the main trends in EL development. The EL is the subject of e-librarianship, the newest specific discipline of the library science.
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Hawking, Paul, Andrew Stein, and Susan Foster. "e-HR and Employee Self Service: A Case Study of a Victorian Public Sector Organisation." In InSITE 2004: Informing Science + IT Education Conference. Informing Science Institute, 2004. http://dx.doi.org/10.28945/2757.
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The application of the internet to the Human Resource function (e-HR) combines two elements: one is the use of electronic media whilst the other is the active participation of employees in the process. These two elements drive the technology that helps organisations lower administration costs, improve employee communication and satisfaction, provide real time access to information while at the same time reducing processing time. This technology holds out the promise of challenging the past role of HR as one of payroll processing and manual administrative processes to one where cost efficiencies can be gained, enabling more time and energy to be devoted to strategic business issues. The relative quick gains with low associated risk have prompted many Australian companies to realise what can be achieved through the implementation of a business to employee (B2E) model. Employee Self Service (ESS), a solution based on the B2E model enables employees to access the corporate human resource information system 24x7. This paper adopts a case study approach with a view to investigating the benefits and associated issues obtained from an implementation of an ESS in an Australian public sector organisation.Keywords: Employee Self Service, e-Human Resources, B2E, HRMIS, ERP Systems, Australian Case Study
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Baranov, V., and R. Gnutikov. "Tools of extraction and procedures of preparation of linguistic data for statistic analysis in the historical corpus «Manuscript»." In Historical research in the context of data science: Information resources, analytical methods and digital technologies. LLC MAKS Press, 2020. http://dx.doi.org/10.29003/m1797.978-5-317-06529-4/113-119.
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Considered is the task of automatic reduction of the text forms with variable graphics and orthography of the corpus “Manuscript” (manuscripts.ru), comprising exact transcriptions of Slavonic medieval manuscripts, to one and only one lemma, which is necessary for correct statistic analysis of the corpus linguistic data. Several ways and procedures of comparison of normalized forms, which are available in the corpus electronic dictionary, with the text forms are proposed.
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Baranov, V., and R. Gnutikov. "Tools of extraction and procedures of preparation of linguistic data for statistic analysis in the historical corpus «Manuscript»." In Historical research in the context of data science: Information resources, analytical methods and digital technologies. LLC MAKS Press, 2020. http://dx.doi.org/10.29003/m1797.978-5-317-06529-4/113-119.
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Considered is the task of automatic reduction of the text forms with variable graphics and orthography of the corpus “Manuscript” (manuscripts.ru), comprising exact transcriptions of Slavonic medieval manuscripts, to one and only one lemma, which is necessary for correct statistic analysis of the corpus linguistic data. Several ways and procedures of comparison of normalized forms, which are available in the corpus electronic dictionary, with the text forms are proposed.
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Vysotska, Victoria, Lyubomyr Chyrun, and Liliya Chyrun. "Information technology of processing information resources in electronic content commerce systems." In 2016 XIth International Scientific and Technical Conference “Computer Sciences and Information Technologies (CSIT). IEEE, 2016. http://dx.doi.org/10.1109/stc-csit.2016.7589909.
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Molchanova, Irma. "USING ELECTRONIC EDUCATIONAL RESOURCES FOR TEACHING RUSSIAN AS A FOREIGN LANGUAGE TO MEDICAL STUDENTS." In 5th SGEM International Multidisciplinary Scientific Conferences on SOCIAL SCIENCES and ARTS SGEM2018. STEF92 Technology, 2018. http://dx.doi.org/10.5593/sgemsocial2018/3.4/s13.114.
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Zhao, Lili, Lishu Zhang, and Dake Wang. "Research on the Development and Management of Library Electronic Information Resources." In Proceedings of the 2nd International Conference on Contemporary Education, Social Sciences and Ecological Studies (CESSES 2019). Paris, France: Atlantis Press, 2019. http://dx.doi.org/10.2991/cesses-19.2019.195.
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Jonaityte, Ieva, and Linas Petkevicius. "Analysis of Information Compression of Medical Images for Survival Models." In 2021 IEEE Open Conference of Electrical, Electronic and Information Sciences (eStream). IEEE, 2021. http://dx.doi.org/10.1109/estream53087.2021.9431461.
Full textReports on the topic "Medical sciences Electronic information resources"
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Qu, Pengda, Jing Huang, Shiqi Wang, Qian Hu, Size Li, Wei Wang, Jiangyun Peng, and Xiaohu Tang. Efficacy and safety of Chinese medicinal formula containing Cortex Phellodendri for gout: A protocol for a systematic review and meta-analysis. INPLASY - International Platform of Registered Systematic Review and Meta-analysis Protocols, May 2022. http://dx.doi.org/10.37766/inplasy2022.5.0109.
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Review question / Objective: The purpose of this study was to compare the efficacy and safety of Chinese medicinal formula containing Cortex Phellodendri and traditional western medicine in the treatment of gout. Information sources: The following databases will be searched on the same day: Web of Science, PubMed, Cochrane Library, Embase, China National Knowledge Infrastructure (CNKI), Wanfang Data Knowledge Service Platform (Wanfang), Weipu Chinese Science and Technology Journal Full-text Database (VIP) and Chinese Biomedical Literature Database (CBM). The retrieval time is from the inception of the database to May 2022. At the same time, we will retrieve other resources to make up for the shortage of electronic database, mainly searching for the clinical trial registries and grey literature about Chinese herbal decoction containing Cortex Phellodendri for gout on the corresponding website. In addition, the relevant journals, in the reference literature, will be searched and tracked.
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Soroko, Nataliia V., Lorena A. Mykhailenko, Olena G. Rokoman, and Vladimir I. Zaselskiy. Educational electronic platforms for STEAM-oriented learning environment at general education school. [б. в.], July 2020. http://dx.doi.org/10.31812/123456789/3884.
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The article is devoted to the problem of the use of educational electronic platform for the organization of a STEAM-oriented environment of the general school. The purpose of the article is to analyze the use of educational electronic platforms for organizing the STEAM-oriented school learning environment and to identify the basic requirements for supporting the implementation and development of STEAM education in Ukraine. One of the main trends of education modernization is the STEAM education, which involves the integration between the natural sciences, the technological sciences, engineering, mathematics and art in the learning process of educational institutions, in particular, general school. The main components of electronic platform for education of the organization STEAM-oriented educational environment should be open e-learning and educational resources that include resources for students and resources for teachers; information and communication technologies that provide communication and collaboration among students; between teachers; between students and teachers; between specialists, employers, students, and teachers; information and communication technologies that promote the development of STEAM education and its implementation in the educational process of the school; online assessment and self-assessment of skills and competences in STEAM education and information and communication technologies fields; STEAM education labs that may include simulators, games, imitation models, etc.; STEAM-oriented educational environment profiles that reflect unconfirmed participants’ data, their contributions to projects and STEAM education, plans, ideas, personal forums, and more. Prospects for further research are the design of an educational electronic platform for the organization of the STEAM-oriented learning environment in accordance with the requirements specified in the paper.
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Smit, Amelia, Kate Dunlop, Nehal Singh, Diona Damian, Kylie Vuong, and Anne Cust. Primary prevention of skin cancer in primary care settings. The Sax Institute, August 2022. http://dx.doi.org/10.57022/qpsm1481.
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Overview Skin cancer prevention is a component of the new Cancer Plan 2022–27, which guides the work of the Cancer Institute NSW. To lessen the impact of skin cancer on the community, the Cancer Institute NSW works closely with the NSW Skin Cancer Prevention Advisory Committee, comprising governmental and non-governmental organisation representatives, to develop and implement the NSW Skin Cancer Prevention Strategy. Primary Health Networks and primary care providers are seen as important stakeholders in this work. To guide improvements in skin cancer prevention and inform the development of the next NSW Skin Cancer Prevention Strategy, an up-to-date review of the evidence on the effectiveness and feasibility of skin cancer prevention activities in primary care is required. A research team led by the Daffodil Centre, a joint venture between the University of Sydney and Cancer Council NSW, was contracted to undertake an Evidence Check review to address the questions below. Evidence Check questions This Evidence Check aimed to address the following questions: Question 1: What skin cancer primary prevention activities can be effectively administered in primary care settings? As part of this, identify the key components of such messages, strategies, programs or initiatives that have been effectively implemented and their feasibility in the NSW/Australian context. Question 2: What are the main barriers and enablers for primary care providers in delivering skin cancer primary prevention activities within their setting? Summary of methods The research team conducted a detailed analysis of the published and grey literature, based on a comprehensive search. We developed the search strategy in consultation with a medical librarian at the University of Sydney and the Cancer Institute NSW team, and implemented it across the databases Embase, MEDLINE, PsycInfo, Scopus, Cochrane Central and CINAHL. Results were exported and uploaded to Covidence for screening and further selection. The search strategy was designed according to the SPIDER tool for Qualitative and Mixed-Methods Evidence Synthesis, which is a systematic strategy for searching qualitative and mixed-methods research studies. The SPIDER tool facilitates rigour in research by defining key elements of non-quantitative research questions. We included peer-reviewed and grey literature that included skin cancer primary prevention strategies/ interventions/ techniques/ programs within primary care settings, e.g. involving general practitioners and primary care nurses. The literature was limited to publications since 2014, and for studies or programs conducted in Australia, the UK, New Zealand, Canada, Ireland, Western Europe and Scandinavia. We also included relevant systematic reviews and evidence syntheses based on a range of international evidence where also relevant to the Australian context. To address Question 1, about the effectiveness of skin cancer prevention activities in primary care settings, we summarised findings from the Evidence Check according to different skin cancer prevention activities. To address Question 2, about the barriers and enablers of skin cancer prevention activities in primary care settings, we summarised findings according to the Consolidated Framework for Implementation Research (CFIR). The CFIR is a framework for identifying important implementation considerations for novel interventions in healthcare settings and provides a practical guide for systematically assessing potential barriers and facilitators in preparation for implementing a new activity or program. We assessed study quality using the National Health and Medical Research Council (NHMRC) levels of evidence. Key findings We identified 25 peer-reviewed journal articles that met the eligibility criteria and we included these in the Evidence Check. Eight of the studies were conducted in Australia, six in the UK, and the others elsewhere (mainly other European countries). In addition, the grey literature search identified four relevant guidelines, 12 education/training resources, two Cancer Care pathways, two position statements, three reports and five other resources that we included in the Evidence Check. Question 1 (related to effectiveness) We categorised the studies into different types of skin cancer prevention activities: behavioural counselling (n=3); risk assessment and delivering risk-tailored information (n=10); new technologies for early detection and accompanying prevention advice (n=4); and education and training programs for general practitioners (GPs) and primary care nurses regarding skin cancer prevention (n=3). There was good evidence that behavioural counselling interventions can result in a small improvement in sun protection behaviours among adults with fair skin types (defined as ivory or pale skin, light hair and eye colour, freckles, or those who sunburn easily), which would include the majority of Australians. It was found that clinicians play an important role in counselling patients about sun-protective behaviours, and recommended tailoring messages to the age and demographics of target groups (e.g. high-risk groups) to have maximal influence on behaviours. Several web-based melanoma risk prediction tools are now available in Australia, mainly designed for health professionals to identify patients’ risk of a new or subsequent primary melanoma and guide discussions with patients about primary prevention and early detection. Intervention studies have demonstrated that use of these melanoma risk prediction tools is feasible and acceptable to participants in primary care settings, and there is some evidence, including from Australian studies, that using these risk prediction tools to tailor primary prevention and early detection messages can improve sun-related behaviours. Some studies examined novel technologies, such as apps, to support early detection through skin examinations, including a very limited focus on the provision of preventive advice. These novel technologies are still largely in the research domain rather than recommended for routine use but provide a potential future opportunity to incorporate more primary prevention tailored advice. There are a number of online short courses available for primary healthcare professionals specifically focusing on skin cancer prevention. Most education and training programs for GPs and primary care nurses in the field of skin cancer focus on treatment and early detection, though some programs have specifically incorporated primary prevention education and training. A notable example is the Dermoscopy for Victorian General Practice Program, in which 93% of participating GPs reported that they had increased preventive information provided to high-risk patients and during skin examinations. Question 2 (related to barriers and enablers) Key enablers of performing skin cancer prevention activities in primary care settings included: • Easy access and availability of guidelines and point-of-care tools and resources • A fit with existing workflows and systems, so there is minimal disruption to flow of care • Easy-to-understand patient information • Using the waiting room for collection of risk assessment information on an electronic device such as an iPad/tablet where possible • Pairing with early detection activities • Sharing of successful programs across jurisdictions. Key barriers to performing skin cancer prevention activities in primary care settings included: • Unclear requirements and lack of confidence (self-efficacy) about prevention counselling • Limited availability of GP services especially in regional and remote areas • Competing demands, low priority, lack of time • Lack of incentives.
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Rankin, Nicole, Deborah McGregor, Candice Donnelly, Bethany Van Dort, Richard De Abreu Lourenco, Anne Cust, and Emily Stone. Lung cancer screening using low-dose computed tomography for high risk populations: Investigating effectiveness and screening program implementation considerations: An Evidence Check rapid review brokered by the Sax Institute (www.saxinstitute.org.au) for the Cancer Institute NSW. The Sax Institute, October 2019. http://dx.doi.org/10.57022/clzt5093.
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Background Lung cancer is the number one cause of cancer death worldwide.(1) It is the fifth most commonly diagnosed cancer in Australia (12,741 cases diagnosed in 2018) and the leading cause of cancer death.(2) The number of years of potential life lost to lung cancer in Australia is estimated to be 58,450, similar to that of colorectal and breast cancer combined.(3) While tobacco control strategies are most effective for disease prevention in the general population, early detection via low dose computed tomography (LDCT) screening in high-risk populations is a viable option for detecting asymptomatic disease in current (13%) and former (24%) Australian smokers.(4) The purpose of this Evidence Check review is to identify and analyse existing and emerging evidence for LDCT lung cancer screening in high-risk individuals to guide future program and policy planning. Evidence Check questions This review aimed to address the following questions: 1. What is the evidence for the effectiveness of lung cancer screening for higher-risk individuals? 2. What is the evidence of potential harms from lung cancer screening for higher-risk individuals? 3. What are the main components of recent major lung cancer screening programs or trials? 4. What is the cost-effectiveness of lung cancer screening programs (include studies of cost–utility)? Summary of methods The authors searched the peer-reviewed literature across three databases (MEDLINE, PsycINFO and Embase) for existing systematic reviews and original studies published between 1 January 2009 and 8 August 2019. Fifteen systematic reviews (of which 8 were contemporary) and 64 original publications met the inclusion criteria set across the four questions. Key findings Question 1: What is the evidence for the effectiveness of lung cancer screening for higher-risk individuals? There is sufficient evidence from systematic reviews and meta-analyses of combined (pooled) data from screening trials (of high-risk individuals) to indicate that LDCT examination is clinically effective in reducing lung cancer mortality. In 2011, the landmark National Lung Cancer Screening Trial (NLST, a large-scale randomised controlled trial [RCT] conducted in the US) reported a 20% (95% CI 6.8% – 26.7%; P=0.004) relative reduction in mortality among long-term heavy smokers over three rounds of annual screening. High-risk eligibility criteria was defined as people aged 55–74 years with a smoking history of ≥30 pack-years (years in which a smoker has consumed 20-plus cigarettes each day) and, for former smokers, ≥30 pack-years and have quit within the past 15 years.(5) All-cause mortality was reduced by 6.7% (95% CI, 1.2% – 13.6%; P=0.02). Initial data from the second landmark RCT, the NEderlands-Leuvens Longkanker Screenings ONderzoek (known as the NELSON trial), have found an even greater reduction of 26% (95% CI, 9% – 41%) in lung cancer mortality, with full trial results yet to be published.(6, 7) Pooled analyses, including several smaller-scale European LDCT screening trials insufficiently powered in their own right, collectively demonstrate a statistically significant reduction in lung cancer mortality (RR 0.82, 95% CI 0.73–0.91).(8) Despite the reduction in all-cause mortality found in the NLST, pooled analyses of seven trials found no statistically significant difference in all-cause mortality (RR 0.95, 95% CI 0.90–1.00).(8) However, cancer-specific mortality is currently the most relevant outcome in cancer screening trials. These seven trials demonstrated a significantly greater proportion of early stage cancers in LDCT groups compared with controls (RR 2.08, 95% CI 1.43–3.03). Thus, when considering results across mortality outcomes and early stage cancers diagnosed, LDCT screening is considered to be clinically effective. Question 2: What is the evidence of potential harms from lung cancer screening for higher-risk individuals? The harms of LDCT lung cancer screening include false positive tests and the consequences of unnecessary invasive follow-up procedures for conditions that are eventually diagnosed as benign. While LDCT screening leads to an increased frequency of invasive procedures, it does not result in greater mortality soon after an invasive procedure (in trial settings when compared with the control arm).(8) Overdiagnosis, exposure to radiation, psychological distress and an impact on quality of life are other known harms. Systematic review evidence indicates the benefits of LDCT screening are likely to outweigh the harms. The potential harms are likely to be reduced as refinements are made to LDCT screening protocols through: i) the application of risk predication models (e.g. the PLCOm2012), which enable a more accurate selection of the high-risk population through the use of specific criteria (beyond age and smoking history); ii) the use of nodule management algorithms (e.g. Lung-RADS, PanCan), which assist in the diagnostic evaluation of screen-detected nodules and cancers (e.g. more precise volumetric assessment of nodules); and, iii) more judicious selection of patients for invasive procedures. Recent evidence suggests a positive LDCT result may transiently increase psychological distress but does not have long-term adverse effects on psychological distress or health-related quality of life (HRQoL). With regards to smoking cessation, there is no evidence to suggest screening participation invokes a false sense of assurance in smokers, nor a reduction in motivation to quit. The NELSON and Danish trials found no difference in smoking cessation rates between LDCT screening and control groups. Higher net cessation rates, compared with general population, suggest those who participate in screening trials may already be motivated to quit. Question 3: What are the main components of recent major lung cancer screening programs or trials? There are no systematic reviews that capture the main components of recent major lung cancer screening trials and programs. We extracted evidence from original studies and clinical guidance documents and organised this into key groups to form a concise set of components for potential implementation of a national lung cancer screening program in Australia: 1. Identifying the high-risk population: recruitment, eligibility, selection and referral 2. Educating the public, people at high risk and healthcare providers; this includes creating awareness of lung cancer, the benefits and harms of LDCT screening, and shared decision-making 3. Components necessary for health services to deliver a screening program: a. Planning phase: e.g. human resources to coordinate the program, electronic data systems that integrate medical records information and link to an established national registry b. Implementation phase: e.g. human and technological resources required to conduct LDCT examinations, interpretation of reports and communication of results to participants c. Monitoring and evaluation phase: e.g. monitoring outcomes across patients, radiological reporting, compliance with established standards and a quality assurance program 4. Data reporting and research, e.g. audit and feedback to multidisciplinary teams, reporting outcomes to enhance international research into LDCT screening 5. Incorporation of smoking cessation interventions, e.g. specific programs designed for LDCT screening or referral to existing community or hospital-based services that deliver cessation interventions. Most original studies are single-institution evaluations that contain descriptive data about the processes required to establish and implement a high-risk population-based screening program. Across all studies there is a consistent message as to the challenges and complexities of establishing LDCT screening programs to attract people at high risk who will receive the greatest benefits from participation. With regards to smoking cessation, evidence from one systematic review indicates the optimal strategy for incorporating smoking cessation interventions into a LDCT screening program is unclear. There is widespread agreement that LDCT screening attendance presents a ‘teachable moment’ for cessation advice, especially among those people who receive a positive scan result. Smoking cessation is an area of significant research investment; for instance, eight US-based clinical trials are now underway that aim to address how best to design and deliver cessation programs within large-scale LDCT screening programs.(9) Question 4: What is the cost-effectiveness of lung cancer screening programs (include studies of cost–utility)? Assessing the value or cost-effectiveness of LDCT screening involves a complex interplay of factors including data on effectiveness and costs, and institutional context. A key input is data about the effectiveness of potential and current screening programs with respect to case detection, and the likely outcomes of treating those cases sooner (in the presence of LDCT screening) as opposed to later (in the absence of LDCT screening). Evidence about the cost-effectiveness of LDCT screening programs has been summarised in two systematic reviews. We identified a further 13 studies—five modelling studies, one discrete choice experiment and seven articles—that used a variety of methods to assess cost-effectiveness. Three modelling studies indicated LDCT screening was cost-effective in the settings of the US and Europe. Two studies—one from Australia and one from New Zealand—reported LDCT screening would not be cost-effective using NLST-like protocols. We anticipate that, following the full publication of the NELSON trial, cost-effectiveness studies will likely be updated with new data that reduce uncertainty about factors that influence modelling outcomes, including the findings of indeterminate nodules. Gaps in the evidence There is a large and accessible body of evidence as to the effectiveness (Q1) and harms (Q2) of LDCT screening for lung cancer. Nevertheless, there are significant gaps in the evidence about the program components that are required to implement an effective LDCT screening program (Q3). Questions about LDCT screening acceptability and feasibility were not explicitly included in the scope. However, as the evidence is based primarily on US programs and UK pilot studies, the relevance to the local setting requires careful consideration. The Queensland Lung Cancer Screening Study provides feasibility data about clinical aspects of LDCT screening but little about program design. The International Lung Screening Trial is still in the recruitment phase and findings are not yet available for inclusion in this Evidence Check. The Australian Population Based Screening Framework was developed to “inform decision-makers on the key issues to be considered when assessing potential screening programs in Australia”.(10) As the Framework is specific to population-based, rather than high-risk, screening programs, there is a lack of clarity about transferability of criteria. However, the Framework criteria do stipulate that a screening program must be acceptable to “important subgroups such as target participants who are from culturally and linguistically diverse backgrounds, Aboriginal and Torres Strait Islander people, people from disadvantaged groups and people with a disability”.(10) An extensive search of the literature highlighted that there is very little information about the acceptability of LDCT screening to these population groups in Australia. Yet they are part of the high-risk population.(10) There are also considerable gaps in the evidence about the cost-effectiveness of LDCT screening in different settings, including Australia. The evidence base in this area is rapidly evolving and is likely to include new data from the NELSON trial and incorporate data about the costs of targeted- and immuno-therapies as these treatments become more widely available in Australia.