Papers by Miguel Angel Mayer
The Lancet Respiratory Medicine, 2021
HAL is a multi-disciplinary open access archive for the deposit and dissemination of scientific r... more HAL is a multi-disciplinary open access archive for the deposit and dissemination of scientific research documents, whether they are published or not. The documents may come from teaching and research institutions in France or abroad, or from public or private research centers. L'archive ouverte pluridisciplinaire HAL, est destinée au dépôt et à la diffusion de documents scientifiques de niveau recherche, publiés ou non, émanant des établissements d'enseignement et de recherche français ou étrangers, des laboratoires publics ou privés.
Yearbook of medical informatics, Aug 1, 2016
Objectives: Social media is increasingly being used in conjunction with health information techno... more Objectives: Social media is increasingly being used in conjunction with health information technology (health IT). The objective of this paper is to identify some of the undesirable outcomes that arise from this integration and to suggest solutions to these problems. Methodology: After a discussion with experts to elicit the topics that should be included in the survey, we performed a narrative review based on recent literature and interviewed multidisciplinary experts from different areas. In each case, we identified and analyzed the unintended effects of social media in health IT. Results: Each analyzed topic provided a different set of unintended consequences. Most relevant consequences include lack of privacy with ethical and legal issues, patient confusion in disease management, poor information accuracy in crowdsourcing, unclear responsibilities, misleading and biased information in the prevention and detection of epidemics, and demotivation in gamified health solutions with social components. Conclusions: Using social media in healthcare offers several benefits, but it is not exempt of potential problems, and not all of these problems have clear solutions. We recommend careful design of digital systems in order to minimize patient's feelings of demotivation and frustration and we recommend following specific guidelines that should be created by all stakeholders in the healthcare ecosystem.
PubMed, 2003
We describe MedCIRCLE, an EU-funded semantic web project to implement the first steps towards a g... more We describe MedCIRCLE, an EU-funded semantic web project to implement the first steps towards a global, collaborative rating and guidance system for health information proposed in the MedCERTAIN project. In MedCIRCLE, three European gateway sites for consumer health information will implement the metadata vocabulary HIDDEL (Health Information Disclosure, Description and Evaluation Language). HIDDEL allows portals and gateways to make the results of their evaluations accessible as XML/RDF. The three participating national portals are: AQUMED (Agency for Quality in Medicine) patienten-information, de, COMB (Official Medical College of Barcelona) and CISMeF, a quality-controlled health gateway developed at Rouen University Hospital. Other health subject gateways, accreditation, or rating services are invited to join the collaboration simply by implementing HIDDEL on their gateways. Widespread implementation HIDDEL will allow intelligent agents or client-side software to harvest statements and opinions about the trustworthiness of other websites, assisting users in selecting trustworthy websites. The MedCIRCLE project builds on, expands and continues work on rating health information on the Internet piloted within the MedCERTAIN project. While MedCERTAIN provided the core technologies and software for rating and "trustmarking" health information, MedCIRCLE is built around these technologies and involves a wider medical community to assess health information, demonstrating the power of collaborative and interoperable evaluations in a semantic web environment. MedCIRCLE is a project with the overall objective to develop and promote technologies able to guide consumers to trustworthy health information on the Internet, to establish a global web of trust for networked health information, and to empower consumers to positively select high quality health information on the web. Other aims include refinement and expansion of HIDDEL, to become a standard vocabulary and interchange format for self- and third-party ratings of health information.
Yearbook of medical informatics, Aug 1, 2015
Objective: Social media, web and mobile technologies are increasingly used in healthcare and dire... more Objective: Social media, web and mobile technologies are increasingly used in healthcare and directly support patientcentered care. Patients benefit from disease self-management tools, contact to others, and closer monitoring. Researchers study drug efficiency, or recruit patients for clinical studies via these technologies. However, low communication barriers in socialmedia, limited privacy and security issues lead to problems from an ethical perspective. This paper summarizes the ethical issues to be considered when social media is exploited in healthcare contexts. Methods: Starting from our experiences in social-media research, we collected ethical issues for selected social-media use cases in the context of patient-centered care. Results were enriched by collecting and analyzing relevant literature and were discussed and interpreted by members of the IMIA Social Media Working Group. Results: Most relevant issues in social-media applications are confidence and privacy that need to be carefully preserved. The patient-physician relationship can suffer from the new information gain on both sides since private information of both healthcare provider and consumer may be accessible through the Internet. Physicians need to ensure they keep the borders between private and professional intact. Beyond, preserving patient anonymity when citing Internet content is crucial for research studies. Conclusion: Exploiting medical social-media in healthcare applications requires a careful reflection of roles and responsibilities. Availability of data and information can be useful in many settings, but the abuse of data needs to be prevented. Preserving privacy and confidentiality of online users is a main issue, as well as providing means for patients or Internet users to express concerns on data usage.
I+S: Revista de la Sociedad Española de Informática y Salud, 2021
Atencion Primaria, 2002
Palabras clave: Mantenimiento con heroína. Reducción de daños. Políticas sobre drogas. Dependenci... more Palabras clave: Mantenimiento con heroína. Reducción de daños. Políticas sobre drogas. Dependencia de opiáceos. Salud pública. Ética.
Computer Methods and Programs in Biomedicine, Apr 1, 2016
Background: In the last few years the use of social media in medicine has grown exponentially, pr... more Background: In the last few years the use of social media in medicine has grown exponentially, providing a new area of research based on the analysis and use of W e b 2.0 capabilities. In addition, the use of social media in medical education is a subject of particular interest which has been addressed in several studies. One example of this application is the medical quizzes of The New England Journal of Medicine (NEJM) that regularly publishes a set of questions through their Facebook timeline. Objective: We present an approach for the automatic extraction of medical quizzes and their associated answers on a Facebook platform by means of a set of computer-based methods and algorithms. Methods: We have developed a tool for the extraction and analysis of medical quizzes stored on Facebook timeline at the NEJM Facebook page, based on a set of computer-based methods and algorithms using Java. The system is divided into two main modules: Crawler and Data retrieval. Results: The system was launched on December 31, 2014 and crawled through a total of 3004 valid posts and 200,081 valid comments. The first post was dated on July 23, 2009 and the last one on December 30, 2014. 285 quizzes were analyzed with 32,780 different users providing answers to the aforementioned quizzes. Of the 285 quizzes, patterns were found in 261 (91.58%). From these 261 quizzes where trends were found, we saw that users follow trends of incorrect answers in 13 quizzes and trends of correct answers in 248. Conclusions: This tool is capable of automatically identifying the correct and wrong answers to a quiz provided on Facebook posts in a text format to a quiz, with a small rate of false negative cases and this approach could be applicable to the extraction and analysis of other sources after including some adaptations of the information on the Internet.
Atencion Primaria, Oct 1, 2004
... Am J Prev Med 2000;18(Suppl 1):97-140. ... En: Vacunaciones en el adulto: guía y recomendacio... more ... Am J Prev Med 2000;18(Suppl 1):97-140. ... En: Vacunaciones en el adulto: guía y recomendaciones. Madrid: José Ramón de Juanes, 2003. 5. Peguero E, Gené J. Estratregias para incrementar las coberturas vacunales en atención primaria. En: Magda C, Moraga F, editores. ...
Atencion Primaria, Dec 1, 2021
Objetivo Evaluar el impacto de los cambios introducidos en respuesta a la pandemia sobre la segur... more Objetivo Evaluar el impacto de los cambios introducidos en respuesta a la pandemia sobre la seguridad del paciente (SP) percibida por los pacientes en Atención Primaria. Diseño Estudio observacional prospectivo de panel (centro de salud [CS]) basado en dos encuestas transversales. Emplazamiento 29 CS de tres regiones sanitarias de España (Mallorca, Cataluña Central y Camp de Tarragona). Participantes Muestreo aleatorio de pacientes que consultaron los CS antes (n=2.199) y durante (n=1.955) la pandemia. Mediciones principales Se administró el cuestionario validado PREOS-PC, que evalúa la SP experimentada por los pacientes atendidos en Atención Primaria. Se compararon las puntuaciones medias en las escalas «experiencias de errores» y «daño» en ambos períodos y se realizaron análisis de regresión multinivel para estudiar las variaciones en las características de los pacientes y de los CS asociadas a la percepción de peores niveles de seguridad. Se realizó un análisis cualitativo de contenido sobre las experiencias de los pacientes durante la pandemia. Resultados Las puntuaciones de «errores» y «daño» empeoraron significativamente durante el período de COVID-19 (92,65 a 88,81 [d de Cohen=0,27]; y 96,92 a 79,97 [d=0,70], respectivamente). Se observó un mayor empeoramiento en mujeres, personas con menor nivel educativo, peor estado de salud y con más años adscritos al centro. También se observaron diferencias en función de la región sanitaria. Conclusiones Durante la pandemia ha empeorado la SP percibida por los pacientes atendidos en Atención Primaria, siendo el impacto desigual según las características sociodemográficas de los pacientes y el perfil de los centros de salud. Objective To evaluate the impact of the changes introduced in response to the pandemic on patient-reported patient safety in Primary Care. Design Prospective observational panel study (health center) based on two cross-sectional surveys. Setting 29 Primary Health Care centers from three Spanish health regions (Mallorca, Catalunya Central and Camp de Tarragona). Participants Random sample of patients visiting their centers before (n =2199 patients) and during the pandemic (n =1955 patients) Main measurements We used the PREOS-PC questionnaire, a validated instrument which assesses patient-reported patient safety in Primary Care. We compared mean scores of the “experiences of errors” and “harm” scales in both periods, and built multilevel regression analyzes to study the variations in patient and center characteristics associated with worse levels of safety. A qualitative (content) analysis of patients’ experiences during the pandemic was also performed. Results The “experiences of errors” and “harm” scales scores significantly worsened during the COVID-19 period (92.65 to 88.81 (Cohen's d =0.27); and 96.92 to 79.97 (d =0.70), respectively). Patient and center characteristics associated to worsened scores were: women, people with a lower educational level, worse health status, more years assigned to the center, and health region. Conclusions During the pandemic, a perceptible worsening in patient safety perceived by patients treated in Primary Care has been observed, which has differentially affected patients according to their sociodemographic characteristics or health center profiles.
American Medical Informatics Association Annual Symposium, 2002
We describe MedCIRCLE, an EU-funded semantic web project to implement the first steps towards a g... more We describe MedCIRCLE, an EU-funded semantic web project to implement the first steps towards a global, collaborative rating and guidance system for health information proposed in the MedCERTAIN project. In MedCIRCLE, three European gateway sites for consumer health information will implement the metadata vocabulary HIDDEL (Health Information Disclosure, Description and Evaluation Language). HIDDEL allows portals and gateways to make the results of their evaluations accessible as XML/RDF. The three participating national portals are: AQUMED (Agency for Quality in Medicine) patienten-information.de, COMB (Official Medical College of Barcelona) and CISMeF, a quality-controlled health gateway developed at Rouen University Hospital. Other health subject gateways, accreditation, or rating services are invited to join the collaboration simply by implementing HIDDEL on their gateways. Widespread implementation HIDDEL will allow intelligent agents or client-side software to harvest statements and opinions about the trustworthiness of other websites, assisting users in selecting trustworthy websites. The MedCIRCLE project builds on, expands and continues work on rating health information on the Internet piloted within the MedCERTAIN project. While MedCERTAIN provided the core technologies and software for rating and "trustmarking" health information, MedCIRCLE is built around these technologies and involves a wider medical community to assess health information, demonstrating the power of collaborative and interoperable evaluations in a semantic web environment. MedCIRCLE is a project with the overall objective to develop and promote technologies able to guide consumers to trustworthy health information on the Internet, to establish a global web of trust for networked health information, and to empower consumers to positively select high quality health information on the web. Other aims include refinement and expansion of HIDDEL, to become a standard vocabulary and interchange format for self-and third-party ratings of health information.
Atencion Primaria, Dec 1, 2020
Atencion Primaria, 2021
Inteligencia artificial; IA; medicina; salud; robótica; BigData Resumen La tecnología y la medici... more Inteligencia artificial; IA; medicina; salud; robótica; BigData Resumen La tecnología y la medicina siguen un camino paralelo durante las últimas décadas. Los avances tecnológicos van modificando el concepto de salud y las necesidades sanitarias están influyendo en el desarrollo de la tecnología. La inteligencia artificial (IA) está formada por una serie de algoritmos lógicos suficientemente entrenados a partir de los cuales las máquinas son capaces de tomar decisiones para casos concretos a partir de normas generales. Esta tecnología tiene aplicaciones en el diagnóstico y seguimiento de pacientes con una evaluación pronóstica individualizada de los mismos. Además,si combinamos esta tecnología con la robótica, podemos crear máquinas inteligentes que hagan propuestas diagnósticas o que sean mucho más eficientes en su trabajo. Por lo tanto la IA va a ser una tecnología presente en nuestro trabajo cotidiano a través de máquinas o programas informáticos, que de manera más o menos transparente para el usuario, van a ir siendo una realidad cotidiana en los procesos sanitarios. Los profesionales sanitarios tenemos que conocer esta tecnología, sus ventajas y sus inconvenientes, porque va a ser una parte integral de nuestro trabajo. En estos dos artículos pretendemos dar una visión básica de esta tecnología adaptada a los médicos con un repaso de su historia y evolución, de sus aplicaciones reales en el momento actual y una visión de un futuro en el que la IA y el Big Data van a conformar la medicina personalizada que caracterizará al siglo XXI.
Alzheimer's & Dementia, 2017
The British journal of general practice : the journal of the Royal College of General Practitioners, 1999
Background Vaccines are among the most successful and cost-effective prevention activities in hea... more Background Vaccines are among the most successful and cost-effective prevention activities in healthcare and in the last few years we have witnessed a remarkable reduction in the number of people suffering from preventable infectious diseases around the world, above all in European Region. At the same time, with the use of the Internet and with the appearance of Social Media platforms, where it is very common for users to share health information, the anti-vaccination activism has found a useful and easy way to spread their messages and philosophy. In this work we describe the features and content of open groups about vaccines on Facebook, the most widely-used social media platform with millions of users around the globe. Objective To determine the features and content of the open groups on Facebook related to vaccines in humans in English and Spanish. Methods We carried out a cross-sectional study on the Internet. Using the Graph API (application programming interface) search engine on Facebook, the open groups about vaccines were searched on the 8th of February. Related keywords about the topic and their variations were used (vaccines, vaccinate, vaccination, anti-vac*, immunization) in English and Spanish. The variables studied were: language of the groups, name and description group, number and gender of users, number of posts, date of creation, the most recent update, user country and category (pro and anti-vaccination groups) based on the name, description and content of the 10 last posts on the wall of each group. A web interface was designed in order to facilitate the process of searching the groups and to manage the keywords and the data files obtained containing the related information. SPSS was used for statistical analysis. Results 318 groups on Facebook were obtained (156 in English (E) and 162 in Spanish (S)) through the Graph API. Among them, in a first step 186 were included in the study to be open groups (98 in English and 88 in Spanish). Of these, 48E and 37S were excluded because the content was unrelated to vaccines in humans or were in other languages (French, Italian, etc.). Finally 101 open groups (50E and 51S) were included with 24,815 members (14,911: 9,984 (67%) women and 4,927 men (33%) in English groups and 9,904: 6,586 women (66.5%) and 3,318 (33.5%) men in Spanish groups). There were a 68% of anti-vaccination groups in English and 55% in Spanish (p=0.176). Conclusions Facebook is used as a means of communication and for sharing health information. There are open groups with information about vaccines on Facebook, the majority of them were anti-vaccination groups, as much in English as Spanish. The Graph API is a very useful tool to collect large data sets on Facebook. More analysis and qualitative studies are needed in order to analyze the type of messages used by anti-vaccination activism to spread its ideas in social media. Health organizations and services should consider participating actively in social media in health promotion and educational activities. []
There is increasing recognition that healthcare providers need to focus attention, and be judged ... more There is increasing recognition that healthcare providers need to focus attention, and be judged against, the impact they have on the health outcomes experienced by patients. The measurement of health outcomes as a routine part of clinical documentation is probably the only scalable way of collecting outcomes evidence, since secondary data collection is expensive and error prone. However, there is uncertainty about whether routinely collected clinical data within EHR systems includes the data most relevant to measuring and comparing outcomes, and if those items are collected to a good enough data quality to be relied upon for outcomes assessment, since several studies have pointed out significant issues regarding EHR data availability and quality.In this paper, we first describe a practical approach to data quality assessment of health outcomes, based on a literature review of existing frameworks for quality assessment of health data and multi-stakeholder consultation. Adopting this...
Drug Safety
Introduction Vaccine-induced thrombotic thrombocytopenia (VITT) has been identified as a rare but... more Introduction Vaccine-induced thrombotic thrombocytopenia (VITT) has been identified as a rare but serious adverse event associated with coronavirus disease 2019 (COVID-19) vaccines. Objectives In this study, we explored the pre-pandemic co-occurrence of thrombosis with thrombocytopenia (TWT) using 17 observational health data sources across the world. We applied multiple TWT definitions, estimated the background rate of TWT, characterized TWT patients, and explored the makeup of thrombosis types among TWT patients. Methods We conducted an international network retrospective cohort study using electronic health records and insurance claims data, estimating background rates of TWT amongst persons observed from 2017 to 2019. Following the principles of existing VITT clinical definitions, TWT was defined as patients with a diagnosis of embolic or thrombotic arterial or venous events and a diagnosis or measurement of thrombocytopenia within 7 days. Six TWT phenotypes were considered, which varied in the approach taken in defining thrombosis and thrombocytopenia in real world data. Results Overall TWT incidence rates ranged from 1.62 to 150.65 per 100,000 person-years. Substantial heterogeneity exists across data sources and by age, sex, and alternative TWT phenotypes. TWT patients were likely to be men of older age with various comorbidities. Among the thrombosis types, arterial thrombotic events were the most common. Conclusion Our findings suggest that identifying VITT in observational data presents a substantial challenge, as implementing VITT case definitions based on the co-occurrence of TWT results in large and heterogeneous incidence rate and in a cohort of patints with baseline characteristics that are inconsistent with the VITT cases reported to date.
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Papers by Miguel Angel Mayer