Data Quality in Health Research: Integrative Literature Review (Preprint)
BACKGROUND Decision-making and strategies to improve service delivery must be supported by reliab... more BACKGROUND Decision-making and strategies to improve service delivery must be supported by reliable health data to generate consistent evidence on health status. The data quality management process must ensure the reliability of collected data. Consequently, various methodologies to improve the quality of services are applied in the health field. At the same time, scientific research is constantly evolving to improve data quality through better reproducibility and empowerment of researchers and offers patient groups tools for secured data sharing and privacy compliance. OBJECTIVE Through an integrative literature review, the aim of this work was to identify and evaluate digital health technology interventions designed to support the conducting of health research based on data quality. METHODS A search was conducted in 6 electronic scientific databases in January 2022: PubMed, SCOPUS, Web of Science, Institute of Electrical and Electronics Engineers Digital Library, Cumulative Index ...
Decision-making and strategies to improve service delivery need to be supported by reliable healt... more Decision-making and strategies to improve service delivery need to be supported by reliable health data to generate consistent evidence on health status, so the data quality management process must ensure the reliability of the data collected. Thus, through an integrative literature review, the main objective of this work is to identify and evaluate digital health technology interventions designed to support the conduct of health research based on data quality. After analyzing and extracting the results of interest, 33 articles were included in the review. This transdisciplinarity may be reaching the threshold of significant growth and thus forcing the need for a metamorphosis of the area from focusing on the measurement and evaluation of data quality, today focused on content, to a direction focused on use and contextIn general, the main barriers reported in relation to the theme of research in the area of health data quality cite circumstances regarding a) use, b) systems and c) h...
Revista da Sociedade Brasileira de Medicina Tropical, 2022
BACKGROUND Non-compliance with latent tuberculosis infection (LTBI) treatment is a reality. The o... more BACKGROUND Non-compliance with latent tuberculosis infection (LTBI) treatment is a reality. The objective of this study was to develop and validate an mobile device application for monitoring the treatment of LTBI. METHODS We defined the requirements, elaborated on the application's conceptual map, generated implementation and prototyping alternatives, and validated content. RESULTS Feedback on the validity of content were: "usefulness, consistency, clarity, objectivity, vocabulary, and precision" from professionals, and "clarity" from patients. CONCLUSIONS The application proved to be easy to understand, according to the assessment of both professionals and people undergoing treatment for LTBI.
COVID-19 BR: A web portal for COVID-19 information in Brazil
Procedia Computer Science, 2022
Brazil is a large developing country that requires attention to regionalized behaviors regarding ... more Brazil is a large developing country that requires attention to regionalized behaviors regarding the dissemination of COVID-19. To deal with this complexity, the COVID-19 Brazil observatory was developed. The Portal aims to monitor and analyze data from different sources. Therefore, with a detailed audit, we centralized this information on the evolution of the disease, allowing for territorial and temporal monitoring. The daily publication of numbers about COVID-19 allowed anyone to follow the current scenario in several Brazilian cities. With about 1,7 million accesses, the Portal offers clarity and an easy understanding of the pandemic data in the country.
The use of guidelines, procedures and recommendations is very common and also a simple way to str... more The use of guidelines, procedures and recommendations is very common and also a simple way to structure, organize and retrieve relevant information that, in turn, may impact on patient care. However, it is necessary to expedite the retrieval of stored information. By simplifying the access to the desired data, it is possible to make the process practical, fast and intuitive for the health professional. The main goal of this article is to present a development approach for a project that proposes decisionmaking tools, based on guidelines, to assist health professionals in the care process of patients with specific diseases (or a combination of them). These tools will be developed for use on mobile devices and as a web-based system, which will transform a passive and declarative manual into an interactive tool that will provide not only data and information, but also knowledge through semantic web paradigm. Further, we will show an example of usability and feasibility of the proposed application through a functional prototype developed for Android platform.
Tuberculosis is the second leading responsible cause of death from infectious diseases. Tuberculo... more Tuberculosis is the second leading responsible cause of death from infectious diseases. Tuberculosis effective control and related activities depends on the use of different systems that aim to assist and monitor patients through managing their health data, and facilitating the activities of several health professionals. However, we noticed disparities in the information provided by some systems, which can negatively impact planning and decision-making. The study is defined as a quantitative and descriptive study of patients' data during the treatment of tuberculosis in two different ambulatories. The data was collected from four different sources, including three information systems and the local patient archive in the ambulatories. Collected data was cleansed and standardized for semantic and structure, which allowed data comparison and analysis for its reliability and completeness. Low reliability scores are due to the absence of a semantic standard and the careless validation on recording of data by the professionals. Therefore, this study was able to effectively detect inconsistencies between the different data sources, stressing the need of health standards for data consistency, interoperability, and promoting data quality.
Background Interoperability of health information systems is a challenge due to the heterogeneity... more Background Interoperability of health information systems is a challenge due to the heterogeneity of existing systems at both the technological and semantic levels of their data. The lack of existing data about interoperability disrupts intra-unit and inter-unit medical operations as well as creates challenges in conducting studies on existing data. The goal is to exchange data while providing the same meaning for data from different sources. Objective To find ways to solve this challenge, this research paper proposes an interoperability solution for the tuberculosis treatment and follow-up scenario in Brazil using Semantic Web technology supported by an ontology. Methods The entities of the ontology were allocated under the definitions of Basic Formal Ontology. Brazilian tuberculosis applications were tagged with entities from the resulting ontology. Results An interoperability layer was developed to retrieve data with the same meaning and in a structured way enabling semantic and ...
Tuberculosis (TB) is an infectious-contagious disease that affects mainly the lungs, ranking in t... more Tuberculosis (TB) is an infectious-contagious disease that affects mainly the lungs, ranking in the 10 main causes of death in the world. Non-adherence or non-treatment of TB may prolong transmissibility, increase the risk of drug resistance and lead to patient death. One step forward is the use of smartphones for monitoring the medication intake via video (VDOT). VDOT is a more acceptable and cost-effective option than the traditional DOT (in person). However, the VDOT system requires a professional (verifying agent) to check all medication intake daily. Based on an initiative that aims to replace the verifying agent with an artificial intelligence tool capable of validating it automatically through computer vision techniques (AI-based VDOT), the main goal of this work is to measure the acceptance and perception of Brazilian health professionals on the AI-Based VDOT before implementing this technology by using a quantitative questionnaire as instrument. To achieve this, we have developed a proposal of study protocol that describes the steps to create, apply and validate this research.
Tuberculosis (TB) was responsible for approximately 1.6 million deaths in 2017 and it is the dead... more Tuberculosis (TB) was responsible for approximately 1.6 million deaths in 2017 and it is the deadliest among the infectious diseases, killing more than Acquired Immunodeficiency Syndrome (AIDS) related diseases. One of the most lethal forms of this disease is the central nervous system TB. The clinical and microbiological diagnosis of tuberculous meningitis (TBM) is still a challenge and to standardize the diagnosis and offer more reliable information to the decision-making process in the clinical practice, predictive scores were created and adapted for the Brazilian context. The score implementation will require staff training but has the potential to reduce time to the TBM diagnosis and therefore start correct treatment early. Although, there is a need to increase the access to the score and to facilitate its use among physicians to save time and resources. This study shows the design and development of a multiplatform mobile application to calculate the predictive score for tuberculous meningitis, in order to support clinical decisions. The preliminary results have shown an effective and versatile App, available to a variety of devices and which can still be available in places with limited or no internet access.
International Journal of E-Health and Medical Communications, 2020
The proliferation of electronic health (e-Health) initiatives in Brazil over the last 2 decades h... more The proliferation of electronic health (e-Health) initiatives in Brazil over the last 2 decades has resulted in a considerable fragmentation within health information technology (IT), with a strong political interference. The problem regarding this issue became twofold: 1) there are considerable flaws regarding interoperability and security involving patient data; and 2) it is difficult even for an experienced company to enter the Brazilian health IT market. In this article, the authors aim to assess the current state of IT interoperability and security in hospitals in Brazil and evaluate the best business strategy for an IT company to enter this difficult but very promising health IT market. A face-to-face questionnaire was conducted among 11 hospital units to assess their current status regarding IT interoperability and security aspects. Global Brazilian socio-economic data was also collected, and helped to not only identify areas of investment regarding health IT security and int...
The evaluation of health software from the point of view of the health professionals is critical ... more The evaluation of health software from the point of view of the health professionals is critical for its success. The work aims to present one of the steps, in this case the usability evaluation, of a more comprehensive protocol of how health software can be evaluated. A software for monitoring tuberculosis treatment (SISTB) was used to test the proposed protocol. The Computer System Usability Questionnaire was the instrument chosen to evaluate software usability. Its adaptation to Portuguese (from Brazil) was performed through three pretests, which obtained high internal consistency, using the Cronbach alpha reliability analysis. SISTB was deployed in three of four referral outpatient clinics for tuberculosis, in the city of Ribeirão Preto, state of São Paulo, Brazil. After three months, health professionals answered the questionnaire. All outpatients presented satisfactory results for usability, showing that the satisfaction degree with software is good and that three months are sufficient for adaptation in relation to the
During the post-marketing period, when the drugs are used by large populations and for longer per... more During the post-marketing period, when the drugs are used by large populations and for longer periods of time, unexpected adverse reactions (AR) may occur, which changes the risk-benefit ratio of the drugs, requiring a Regulatory action. Most post-marketing AR requires a significant increase in health care and result in damage, often fatal, to the patient. Therefore, the early detection of AR in the post-marketing period is the primary goal of a health system, in particular, pharmacovigilance systems. The main objective of this article is to show the stages of the development of an AR notification database to serve as the "gold standard" of a pioneering project in Brazil to process data automatically from the inclusion of electronic reporting systems into the Hospital Information Systems (HIS).
Background: The All Patient-Refined Diagnosis-Related Groups (APR-DRGs) system has adjusted the b... more Background: The All Patient-Refined Diagnosis-Related Groups (APR-DRGs) system has adjusted the basic DRG structure by incorporating four severity of illness (SOI) levels, which are used for determining hospital payment. A comprehensive report of all relevant diagnoses, namely the patient’s underlying co-morbidities, is a key factor for ensuring that SOI determination will be adequate. Objective: In this study, we aimed to characterise the individual impact of co-morbidities on APR-DRG classification and hospital funding in the context of respiratory and cardiovascular diseases. Methods: Using 6 years of coded clinical data from a nationwide Portuguese inpatient database and support vector machine (SVM) models, we simulated and explored the APR-DRG classification to understand its response to individual removal of Charlson and Elixhauser co-morbidities. We also estimated the amount of hospital payments that could have been lost when co-morbidities are under-reported. Results: In our...
Data exchange in health information systems must be carefully planned and needs to be protected f... more Data exchange in health information systems must be carefully planned and needs to be protected from unauthorized access due to sensibility of stored content. Security aspects like authentication, authorization and encryption must be considered in this context. The main goal of this article is to present the implementation of security mechanisms to a semantic API that allows data extraction from a regional health information system designed to create notifications and to follow patients diagnosed with Tuberculosis. Data semantically tagged will be mapped individually to several access levels. It will be showed how external systems can connect, authenticate and retrieve only authorized data that are classified in the scope of its maximum access level.
Assessment of health information systems consider different aspects of the system itself. They fo... more Assessment of health information systems consider different aspects of the system itself. They focus or on the professional who will use the software or on its usability or on the software engineering metrics or on financial and managerial issues. The existent approaches are very resources consuming, disconnected, and not standardized. As the software becomes more critical in the health organizations and in patients, becoming used as a medical device or a medicine, there is an urgency to identify tools and methods that can be applied in the development process. The present work is one of the steps of a broader study to identify standardized protocols to evaluate the health information systems as medicines and medical devices are evaluated by clinical trials. The goal of the present work was to evaluate the effect of the introduction of an information system for monitoring tuberculosis treatment (SISTB) in a Brazilian municipality from the patients' perspective. The Patient Satis...
Doctors, nurses, and other healthcare professionals use software that affects the patients. Direc... more Doctors, nurses, and other healthcare professionals use software that affects the patients. Directly Observed Treatment, Short-course is the name given to the tuberculosis control strategy recommended by the World Health Organization. The main goal of this work is to propose a protocol for evaluating the impact of healthcare software supporting Directly Observed Treatment, Short-course on patients, healthcare professionals, and services. The proposed protocol consists of a set of instruments and steps. The instruments are reliable and validated existing questionnaires to be applied before and after using the software tool. The literature points out the need for standards on the software assessment. This is particularly critical when software affects patients directly. The present protocol is a universal tool to assess the impact of software used to support the fight against the tragedy of tuberculosis where a rigorous evaluation of IT in healthcare is highly recommended and of great...
BJOG: An International Journal of Obstetrics & Gynaecology, 2015
ObjectiveTo generate a global reference for caesarean section (CS) rates at health facilities.Des... more ObjectiveTo generate a global reference for caesarean section (CS) rates at health facilities.DesignCross‐sectional study.SettingHealth facilities from 43 countries.Population/SampleThirty eight thousand three hundred and twenty‐four women giving birth from 22 countries for model building and 10 045 875 women giving birth from 43 countries for model testing.MethodsWe hypothesised that mathematical models could determine the relationship between clinical‐obstetric characteristics and CS. These models generated probabilities of CS that could be compared with the observed CS rates. We devised a three‐step approach to generate the global benchmark of CS rates at health facilities: creation of a multi‐country reference population, building mathematical models, and testing these models.Main outcome measuresArea under the ROC curves, diagnostic odds ratio, expected CS rate, observed CS rate.ResultsAccording to the different versions of the model, areas under the ROC curves suggested a good...
Data Quality in Health Research: Integrative Literature Review (Preprint)
BACKGROUND Decision-making and strategies to improve service delivery must be supported by reliab... more BACKGROUND Decision-making and strategies to improve service delivery must be supported by reliable health data to generate consistent evidence on health status. The data quality management process must ensure the reliability of collected data. Consequently, various methodologies to improve the quality of services are applied in the health field. At the same time, scientific research is constantly evolving to improve data quality through better reproducibility and empowerment of researchers and offers patient groups tools for secured data sharing and privacy compliance. OBJECTIVE Through an integrative literature review, the aim of this work was to identify and evaluate digital health technology interventions designed to support the conducting of health research based on data quality. METHODS A search was conducted in 6 electronic scientific databases in January 2022: PubMed, SCOPUS, Web of Science, Institute of Electrical and Electronics Engineers Digital Library, Cumulative Index ...
Decision-making and strategies to improve service delivery need to be supported by reliable healt... more Decision-making and strategies to improve service delivery need to be supported by reliable health data to generate consistent evidence on health status, so the data quality management process must ensure the reliability of the data collected. Thus, through an integrative literature review, the main objective of this work is to identify and evaluate digital health technology interventions designed to support the conduct of health research based on data quality. After analyzing and extracting the results of interest, 33 articles were included in the review. This transdisciplinarity may be reaching the threshold of significant growth and thus forcing the need for a metamorphosis of the area from focusing on the measurement and evaluation of data quality, today focused on content, to a direction focused on use and contextIn general, the main barriers reported in relation to the theme of research in the area of health data quality cite circumstances regarding a) use, b) systems and c) h...
Revista da Sociedade Brasileira de Medicina Tropical, 2022
BACKGROUND Non-compliance with latent tuberculosis infection (LTBI) treatment is a reality. The o... more BACKGROUND Non-compliance with latent tuberculosis infection (LTBI) treatment is a reality. The objective of this study was to develop and validate an mobile device application for monitoring the treatment of LTBI. METHODS We defined the requirements, elaborated on the application's conceptual map, generated implementation and prototyping alternatives, and validated content. RESULTS Feedback on the validity of content were: "usefulness, consistency, clarity, objectivity, vocabulary, and precision" from professionals, and "clarity" from patients. CONCLUSIONS The application proved to be easy to understand, according to the assessment of both professionals and people undergoing treatment for LTBI.
COVID-19 BR: A web portal for COVID-19 information in Brazil
Procedia Computer Science, 2022
Brazil is a large developing country that requires attention to regionalized behaviors regarding ... more Brazil is a large developing country that requires attention to regionalized behaviors regarding the dissemination of COVID-19. To deal with this complexity, the COVID-19 Brazil observatory was developed. The Portal aims to monitor and analyze data from different sources. Therefore, with a detailed audit, we centralized this information on the evolution of the disease, allowing for territorial and temporal monitoring. The daily publication of numbers about COVID-19 allowed anyone to follow the current scenario in several Brazilian cities. With about 1,7 million accesses, the Portal offers clarity and an easy understanding of the pandemic data in the country.
The use of guidelines, procedures and recommendations is very common and also a simple way to str... more The use of guidelines, procedures and recommendations is very common and also a simple way to structure, organize and retrieve relevant information that, in turn, may impact on patient care. However, it is necessary to expedite the retrieval of stored information. By simplifying the access to the desired data, it is possible to make the process practical, fast and intuitive for the health professional. The main goal of this article is to present a development approach for a project that proposes decisionmaking tools, based on guidelines, to assist health professionals in the care process of patients with specific diseases (or a combination of them). These tools will be developed for use on mobile devices and as a web-based system, which will transform a passive and declarative manual into an interactive tool that will provide not only data and information, but also knowledge through semantic web paradigm. Further, we will show an example of usability and feasibility of the proposed application through a functional prototype developed for Android platform.
Tuberculosis is the second leading responsible cause of death from infectious diseases. Tuberculo... more Tuberculosis is the second leading responsible cause of death from infectious diseases. Tuberculosis effective control and related activities depends on the use of different systems that aim to assist and monitor patients through managing their health data, and facilitating the activities of several health professionals. However, we noticed disparities in the information provided by some systems, which can negatively impact planning and decision-making. The study is defined as a quantitative and descriptive study of patients' data during the treatment of tuberculosis in two different ambulatories. The data was collected from four different sources, including three information systems and the local patient archive in the ambulatories. Collected data was cleansed and standardized for semantic and structure, which allowed data comparison and analysis for its reliability and completeness. Low reliability scores are due to the absence of a semantic standard and the careless validation on recording of data by the professionals. Therefore, this study was able to effectively detect inconsistencies between the different data sources, stressing the need of health standards for data consistency, interoperability, and promoting data quality.
Background Interoperability of health information systems is a challenge due to the heterogeneity... more Background Interoperability of health information systems is a challenge due to the heterogeneity of existing systems at both the technological and semantic levels of their data. The lack of existing data about interoperability disrupts intra-unit and inter-unit medical operations as well as creates challenges in conducting studies on existing data. The goal is to exchange data while providing the same meaning for data from different sources. Objective To find ways to solve this challenge, this research paper proposes an interoperability solution for the tuberculosis treatment and follow-up scenario in Brazil using Semantic Web technology supported by an ontology. Methods The entities of the ontology were allocated under the definitions of Basic Formal Ontology. Brazilian tuberculosis applications were tagged with entities from the resulting ontology. Results An interoperability layer was developed to retrieve data with the same meaning and in a structured way enabling semantic and ...
Tuberculosis (TB) is an infectious-contagious disease that affects mainly the lungs, ranking in t... more Tuberculosis (TB) is an infectious-contagious disease that affects mainly the lungs, ranking in the 10 main causes of death in the world. Non-adherence or non-treatment of TB may prolong transmissibility, increase the risk of drug resistance and lead to patient death. One step forward is the use of smartphones for monitoring the medication intake via video (VDOT). VDOT is a more acceptable and cost-effective option than the traditional DOT (in person). However, the VDOT system requires a professional (verifying agent) to check all medication intake daily. Based on an initiative that aims to replace the verifying agent with an artificial intelligence tool capable of validating it automatically through computer vision techniques (AI-based VDOT), the main goal of this work is to measure the acceptance and perception of Brazilian health professionals on the AI-Based VDOT before implementing this technology by using a quantitative questionnaire as instrument. To achieve this, we have developed a proposal of study protocol that describes the steps to create, apply and validate this research.
Tuberculosis (TB) was responsible for approximately 1.6 million deaths in 2017 and it is the dead... more Tuberculosis (TB) was responsible for approximately 1.6 million deaths in 2017 and it is the deadliest among the infectious diseases, killing more than Acquired Immunodeficiency Syndrome (AIDS) related diseases. One of the most lethal forms of this disease is the central nervous system TB. The clinical and microbiological diagnosis of tuberculous meningitis (TBM) is still a challenge and to standardize the diagnosis and offer more reliable information to the decision-making process in the clinical practice, predictive scores were created and adapted for the Brazilian context. The score implementation will require staff training but has the potential to reduce time to the TBM diagnosis and therefore start correct treatment early. Although, there is a need to increase the access to the score and to facilitate its use among physicians to save time and resources. This study shows the design and development of a multiplatform mobile application to calculate the predictive score for tuberculous meningitis, in order to support clinical decisions. The preliminary results have shown an effective and versatile App, available to a variety of devices and which can still be available in places with limited or no internet access.
International Journal of E-Health and Medical Communications, 2020
The proliferation of electronic health (e-Health) initiatives in Brazil over the last 2 decades h... more The proliferation of electronic health (e-Health) initiatives in Brazil over the last 2 decades has resulted in a considerable fragmentation within health information technology (IT), with a strong political interference. The problem regarding this issue became twofold: 1) there are considerable flaws regarding interoperability and security involving patient data; and 2) it is difficult even for an experienced company to enter the Brazilian health IT market. In this article, the authors aim to assess the current state of IT interoperability and security in hospitals in Brazil and evaluate the best business strategy for an IT company to enter this difficult but very promising health IT market. A face-to-face questionnaire was conducted among 11 hospital units to assess their current status regarding IT interoperability and security aspects. Global Brazilian socio-economic data was also collected, and helped to not only identify areas of investment regarding health IT security and int...
The evaluation of health software from the point of view of the health professionals is critical ... more The evaluation of health software from the point of view of the health professionals is critical for its success. The work aims to present one of the steps, in this case the usability evaluation, of a more comprehensive protocol of how health software can be evaluated. A software for monitoring tuberculosis treatment (SISTB) was used to test the proposed protocol. The Computer System Usability Questionnaire was the instrument chosen to evaluate software usability. Its adaptation to Portuguese (from Brazil) was performed through three pretests, which obtained high internal consistency, using the Cronbach alpha reliability analysis. SISTB was deployed in three of four referral outpatient clinics for tuberculosis, in the city of Ribeirão Preto, state of São Paulo, Brazil. After three months, health professionals answered the questionnaire. All outpatients presented satisfactory results for usability, showing that the satisfaction degree with software is good and that three months are sufficient for adaptation in relation to the
During the post-marketing period, when the drugs are used by large populations and for longer per... more During the post-marketing period, when the drugs are used by large populations and for longer periods of time, unexpected adverse reactions (AR) may occur, which changes the risk-benefit ratio of the drugs, requiring a Regulatory action. Most post-marketing AR requires a significant increase in health care and result in damage, often fatal, to the patient. Therefore, the early detection of AR in the post-marketing period is the primary goal of a health system, in particular, pharmacovigilance systems. The main objective of this article is to show the stages of the development of an AR notification database to serve as the "gold standard" of a pioneering project in Brazil to process data automatically from the inclusion of electronic reporting systems into the Hospital Information Systems (HIS).
Background: The All Patient-Refined Diagnosis-Related Groups (APR-DRGs) system has adjusted the b... more Background: The All Patient-Refined Diagnosis-Related Groups (APR-DRGs) system has adjusted the basic DRG structure by incorporating four severity of illness (SOI) levels, which are used for determining hospital payment. A comprehensive report of all relevant diagnoses, namely the patient’s underlying co-morbidities, is a key factor for ensuring that SOI determination will be adequate. Objective: In this study, we aimed to characterise the individual impact of co-morbidities on APR-DRG classification and hospital funding in the context of respiratory and cardiovascular diseases. Methods: Using 6 years of coded clinical data from a nationwide Portuguese inpatient database and support vector machine (SVM) models, we simulated and explored the APR-DRG classification to understand its response to individual removal of Charlson and Elixhauser co-morbidities. We also estimated the amount of hospital payments that could have been lost when co-morbidities are under-reported. Results: In our...
Data exchange in health information systems must be carefully planned and needs to be protected f... more Data exchange in health information systems must be carefully planned and needs to be protected from unauthorized access due to sensibility of stored content. Security aspects like authentication, authorization and encryption must be considered in this context. The main goal of this article is to present the implementation of security mechanisms to a semantic API that allows data extraction from a regional health information system designed to create notifications and to follow patients diagnosed with Tuberculosis. Data semantically tagged will be mapped individually to several access levels. It will be showed how external systems can connect, authenticate and retrieve only authorized data that are classified in the scope of its maximum access level.
Assessment of health information systems consider different aspects of the system itself. They fo... more Assessment of health information systems consider different aspects of the system itself. They focus or on the professional who will use the software or on its usability or on the software engineering metrics or on financial and managerial issues. The existent approaches are very resources consuming, disconnected, and not standardized. As the software becomes more critical in the health organizations and in patients, becoming used as a medical device or a medicine, there is an urgency to identify tools and methods that can be applied in the development process. The present work is one of the steps of a broader study to identify standardized protocols to evaluate the health information systems as medicines and medical devices are evaluated by clinical trials. The goal of the present work was to evaluate the effect of the introduction of an information system for monitoring tuberculosis treatment (SISTB) in a Brazilian municipality from the patients' perspective. The Patient Satis...
Doctors, nurses, and other healthcare professionals use software that affects the patients. Direc... more Doctors, nurses, and other healthcare professionals use software that affects the patients. Directly Observed Treatment, Short-course is the name given to the tuberculosis control strategy recommended by the World Health Organization. The main goal of this work is to propose a protocol for evaluating the impact of healthcare software supporting Directly Observed Treatment, Short-course on patients, healthcare professionals, and services. The proposed protocol consists of a set of instruments and steps. The instruments are reliable and validated existing questionnaires to be applied before and after using the software tool. The literature points out the need for standards on the software assessment. This is particularly critical when software affects patients directly. The present protocol is a universal tool to assess the impact of software used to support the fight against the tragedy of tuberculosis where a rigorous evaluation of IT in healthcare is highly recommended and of great...
BJOG: An International Journal of Obstetrics & Gynaecology, 2015
ObjectiveTo generate a global reference for caesarean section (CS) rates at health facilities.Des... more ObjectiveTo generate a global reference for caesarean section (CS) rates at health facilities.DesignCross‐sectional study.SettingHealth facilities from 43 countries.Population/SampleThirty eight thousand three hundred and twenty‐four women giving birth from 22 countries for model building and 10 045 875 women giving birth from 43 countries for model testing.MethodsWe hypothesised that mathematical models could determine the relationship between clinical‐obstetric characteristics and CS. These models generated probabilities of CS that could be compared with the observed CS rates. We devised a three‐step approach to generate the global benchmark of CS rates at health facilities: creation of a multi‐country reference population, building mathematical models, and testing these models.Main outcome measuresArea under the ROC curves, diagnostic odds ratio, expected CS rate, observed CS rate.ResultsAccording to the different versions of the model, areas under the ROC curves suggested a good...
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