CURATE.AI COR-Tx platform as a digital therapy and digital diagnostic for cognitive function in patients with brain tumour postradiotherapy treatment: protocol for a prospective mixed-methods feasibility clinical trial

BMJ Open, Год журнала: 2023, Номер 13(10), С. e077219 - e077219

Опубликована: Окт. 1, 2023

Conventional interventional modalities for preserving or improving cognitive function in patients with brain tumour undergoing radiotherapy usually involve pharmacological and/or rehabilitation therapy administered at fixed doses intensities, often resulting suboptimal no response, due to the dynamically evolving patient state over course of disease. The personalisation interventions may result more effective results this population. We have developed CURATE.AI COR-Tx platform, which combines a previously validated, artificial intelligence-derived personalised dosing technology digital training.This is prospective, single-centre, single-arm, mixed-methods feasibility clinical trial primary objective testing platform intervention as both and diagnostic function. Fifteen participants diagnosed requiring will be recruited. Participants undergo remote, home-based 10-week using three times week. Cognitive assessed via combined non-digital evaluation session five time points: preradiotherapy, preintervention postintervention 16-weeks 32-weeks postintervention. Feasibility outcomes relating acceptability, demand, implementation, practicality limited efficacy well usability user experience end through semistructured interviews study team focus group discussion completion. All analysed quantitatively qualitatively.This has been approved by National Healthcare Group (NHG) DSRB (DSRB2020/00249). report our findings scientific conferences peer-reviewed journals.NCT04848935.

Язык: Английский

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Bridging the Gap Between Community Health Workers’ Digital Health Acceptance and Actual Usage in Uganda: Exploring Key External Factors based on Technology Acceptance Model.

Research Square (Research Square), Год журнала: 2023, Номер unknown

Опубликована: Ноя. 7, 2023

Abstract Background Community health systems are poised to play a prominent role in achieving universal coverage low- and middle-income countries, as demonstrated during the COVID-19 pandemic response. The advent of information technology has provided an opportunity optimize community space improve efficiency. However, there is limited knowledge about acceptance usage among workers, prerequisite for scaled implementation. We aimed use model (TAM) predict CHWs, identify external factors understand impact on systems. Methods conducted semistructured interviews with workers who were recruited through both convenience snowball sampling. Data entered using ODK form. Codes induced or deduced from open-ended responses. Cross-tabulation, correlation regression analysis was performed SPSS version 28. Results good predictor behavioral intention digital tools CHWs. actual not well predicted, mismatch between high low usage. Access smartphones found have oversized influence tools. Conclusion According TAM, CHWs accepted but by access smartphones. There also need ensure equitable digitization Last, study further emphasizes

Язык: Английский

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Life cycle cost analysis at scale: a reference architecture-based approach

Built Environment Project and Asset Management, Год журнала: 2024, Номер 14(5), С. 713 - 733

Опубликована: Июль 11, 2024

Purpose This research demonstrates the theoretical merit of a reference architecture-based approach to life cycle cost (LCC) analysis system provision in built environment. LCC insight is considered fundamental sustainable decision making by asset managers; however, current capabilities practice do not align with political ambition and scale competencies required realise sectoral emissions–reduction targets. Design/methodology/approach In pursuing practical outcomes, study employs custom design science research-inspired methodology. Domain requirements are gathered via literature as an initial top-down software architecture which refined, bottom-up, through testing implementation representative case study. A prototype IT artefact developed used evaluate concept qualitatively broad practitioner focus groups. Findings Sentiment expert opinions broadly positive helps substantiate proposal’s suitability addressing scalability challenge. Additionally, constructive feedback provides guidance towards this trajectory, highlighting importance aligning existing communities standards, broadening future scope consider further scenarios prioritisation efforts build trust around contracts data quality. Originality/value The novelty work reusable development Practical implications has potential provide industry at while artefacts herein can be appended standards support developers. Furthermore, methodology employed harmonisation between policy practice.

Язык: Английский

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Human Centered Design – Ein effektives Mittel gegen „Wickedness“ und „Pilotitis“ komplexer Digitalisierungsprojekte?

Health data management, Год журнала: 2024, Номер unknown, С. 675 - 688

Опубликована: Янв. 1, 2024

Die Potenziale eines digitalisierten Gesundheitssystems sind offenkundig. Von unnötigen Doppeluntersuchungen bis hin zur mangelnden Früherkennung – in kaum einem Sektor warten so viele Problemstellungen auf eine digitale Lösung. Gleichzeitig die erhofften Effekte kein Selbstläufer und Berichte über gescheiterte Digitalisierungsprojekte negative häufen sich. Dies gilt insbesondere für komplexe Vorhaben, aus diesem Grund auch mit dem Phänomen der "Wickedness" "Pilotitis" beschrieben werden. Es ist weithin anerkannt, dass Erfolg solcher Projekte von einer gelungenen Abstimmung menschlicher, technischer (inter-)organisatorischer Faktoren abhängt. Eine Erkenntnis, inzwischen zahlreichen Rahmenwerken Eingang gefunden hat (z. B. FITT, NASSS, CeHRes). Obwohl diese erste Orientierung bieten, sie oftmals zu abstrakt einen zielführenden Einsatz. Dieser Beitrag argumentiert, Human Centered Design (HCD) Brücke zwischen Erkenntnis Umsetzung schlagen kann somit vielversprechende Unterstützung IT-Verantwortliche darstellt. Neben Merkmalen Methoden werden Herausforderungen Perspektiven HCD aufgezeigt.

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Navigating the Complexities of Scaling Remote Patient Management: A Scoping Review (Preprint)

Опубликована: Апрель 15, 2024

Large-scale implementation of Remote Patient Management (RPM) promises to improve the overall quality healthcare. However, innovation often remains on a small and local scale due complex, multi-faceted challenges during scaling process RPM. Overcoming these requires thorough understanding process. The current literature is heterogeneous, and, our knowledge, there no comprehensive overview multilevel complexity This scoping review examines how describes RPM, what theoretical frameworks are used factors hinder or enable this Following PRISMA-ScR guidelines, search was conducted in Pubmed Embase databases. resulted inclusion 12 studies. Data extraction focused characteristics included studies, terminology process, applied, influencing studies exhibited considerable heterogeneity methodology, focus, approach describe processes varied, reflecting continuum across RPM lifecycle. 7 were identified that provided mainly descriptive evaluative insights into levels A total 568 (barriers enablers) categorised thematic clusters. Three sources identified: process; management as multi-levelled multitude interconnected categories related transition from pilot scaling. Recommendations for researchers practitioners proposed navigate through complexities, including clear distinction, development multi-level frameworks, holistic assessment factors, creation integrated overarching strategies. Scaling within healthcare systems presents diverse stemming complex nature Addressing more than “just” implementing multiple contexts, it strategic informed by robust actionable recommendations. Future research directions should focus leveraging knowledge develop effective strategies

Язык: Английский

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Key considerations for designing clinical studies to evaluate digital health solutions (Preprint)

Journal of Medical Internet Research, Год журнала: 2024, Номер 26, С. e54518 - e54518

Опубликована: Май 17, 2024

Evidence of clinical impact is critical to unlock the potential digital health solutions (DHSs), yet many are failing deliver positive results. We argue in this viewpoint that failure linked current approaches DHS evaluation design, which neglect numerous key characteristics (KCs) requiring specific scientific and design considerations. first delineate KCs DHSs: (1) they implemented at care system patient levels; (2) "complex" interventions; (3) can drive multiple outcomes indirectly through a multitude smaller benefits; (4) their mechanism action vary between individuals change over time based on needs; (5) develop short, iterative cycles-optimally within real-world use context. Following our objective better alignment unique traits DHSs, we then provide methodological suggestions address these KCs, including tips mechanism-of-action mapping, alternative randomization methods, control-arm adaptations, novel end-point selection, as well innovative methods utilizing data platform research.

Язык: Английский

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Has the pandemic enhanced and sustained digital health-seeking behaviour? A big data interrupted time-series analysis of Google Trends

medRxiv (Cold Spring Harbor Laboratory), Год журнала: 2022, Номер unknown

Опубликована: Июль 30, 2022

Abstract Background Due to the emergency responses early in pandemic, use of digital health healthcare increased abruptly, yet it remains unclear whether this introduction was sustainable on long term. We explore trends health-seeking behaviour as proxy for readiness adopt a mainstream form healthcare. Methods weekly Google Trends data from February 2019 August 2021 Canada, United States, Kingdom, New Zealand, Australia, and Ireland. used five keywords monitor online search interests Trends: doctor, telehealth, health, telemedicine , app . Data are analysed using an interrupted time-series analysis with break-points 11 March 2020 20 December 2020. Results Digital searches immediately all countries after pandemic announcement. There some variance what were per country. However, declined immediate spike, sometimes towards pre-pandemic levels. The exception is volume which showed either remain stable or gradually increase during pandemic. Interpretation Our findings suggest that behavioural patterns associated currently not sustainable. Further building capacity development robust governance literacy frameworks crucial more structurally facilitate transformation across countries. Funding Not applicable.

Язык: Английский

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CURATE.AI COR-Tx platform as a digital therapy and digital diagnostic for cognitive function in brain tumour patients post-radiotherapy treatment: Protocol for a prospective mixed-methods feasibility clinical trial

Research Square (Research Square), Год журнала: 2023, Номер unknown

Опубликована: Янв. 30, 2023

Abstract Background Brain tumour patients undergoing radiotherapy often experience cognitive impairment. Conventional interventional modalities for preserving or improving function usually involve pharmacological and/or rehabilitation therapy. These interventions are typically administered at fixed doses intensities, resulting in sub-optimal no response, due to the dynamically evolving patient state over course of disease. The personalisation such may result more effective results this population. We have developed CURATE.AI COR-Tx platform, which combines a previously validated, artificial intelligence-derived personalised dosing technology with digital training. This platform has potential be used as intervention and diagnostic brain treated radiotherapy. Methods is prospective, single-centre, single-arm, mixed-methods feasibility clinical trial primary objective testing both function. Fifteen participants diagnosed requiring will recruited trial. Participants undergo remote, home-based 10-week using three times week. Cognitive assessed via combined non-digital evaluation session five time points: prior commencement, pre- & post-intervention 16- 32-weeks post-intervention. Feasibility outcomes relating acceptability, demand, implementation, practicality limited efficacy well usability user end through semi-structured interviews study team focus group discussion completion. All analysed quantitatively qualitatively. Discussion immediate goal research assess an appropriate population inform definitive, future, multi-site, randomised within setting. Additionally, if proves feasible limited-efficacy positive, lead advancement post-radiotherapy care survivors likely improvements daily lives these individuals their caregivers. Trial registration NCT04848935

Язык: Английский

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Physicians’ Perspectives on AI in Clinical Decision Support Systems: Interview Study of the CURATE.AI Personalized Dose Optimization Platform (Preprint)

Опубликована: Апрель 25, 2023

Physicians play a key role in integrating new clinical technology into care practices through user feedback and growth propositions to developers of the technology. As physicians are stakeholders involved iteration process, understanding their roles as users can provide nuanced insights workings these technologies that being explored. Therefore, physicians’ perceptions be critical toward validation, implementation, downstream adoption. Given increasing prevalence decision support systems (CDSSs), there remains need gain an in-depth expectations implementation. This paper explores CURATE.AI, novel artificial intelligence (AI)–based stage personalized dosing CDSSs, practice. study aims understand perspectives CURATE.AI for work gather on considerations implementation AI-based CDSS tools. A total 12 participants completed semistructured interviews examining knowledge, experience, attitudes, risks, future course combination therapy platform, CURATE.AI. Interviews were audio recorded, transcribed verbatim, coded manually. The data thematically analyzed. Overall, 3 broad themes 9 subthemes identified thematic analysis. covered perceived significant across various stages development, including trial, mass laid out ways interpreted CDSS, research pointed during different exploration layered with relevant researchers.

Язык: Английский

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Barriers and facilitators for the pre-adoption of computer-aided diagnosis tools for cervical cancer: A qualitative study on healthcare providers’ perspectives in West Cameroon (Preprint)

Опубликована: Окт. 13, 2023

Digital medicine shows high potential to improve patient care management around the world. Even though a digital solution is technologically well implemented, its sustained use can be hindered by numerous factors. Consequently, technology may fail progress beyond pilot stage and never reach end-users nor patients. In field of cervical cancer, many computer-aided diagnosis (CAD) algorithms have been developed for assessment lesions but require further investigation in terms feasibility effectiveness real clinical conditions. The current study focuses on challenges perceived healthcare providers (HCPs) cancer CAD tool visual inspection with acetic acid (VIA) West Cameroon. It aims identify common barriers facilitators ensure smooth adoption technology, that specific context use, also wider settings. A qualitative methodology was used main solutions those challenges. Participants this include 8 HCPs (6 midwives 2 gynaecologists), all working district Dschang While focus groups were conducted discuss midwives, individual interviews explored perspectives medical doctors. All audio-recorded, transcribed then coded independently two researchers using ATLAS.ti software. Technology Acceptance Lifecycle as framework analyse results. identified key elements influencing tools VIA part pre-adoption phase. Barriers ease-of-use system, confidentiality concerns, limited infrastructure resources change workflow. Facilitators mainly encompass validation performance, usability integration care, provision services complementary such tailored training HCPs. This approach would enhance trust without which, cannot achieved. Most importantly, users need involved early regularly provide feedback about ease-of-use, usefulness efficiency system. Focusing Cameroon, provides practical insights regarding CADs addition readiness ease should considered at an development proper end-users. Those deep understanding end user, training, assistance maintenance robust evidence.

Язык: Английский

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