scholarly journals How does medical scribes’ work inform development of speech-based clinical documentation technologies? A systematic review

2020 ◽  
Vol 27 (5) ◽  
pp. 808-817 ◽  
Author(s):  
Brian D Tran ◽  
Yunan Chen ◽  
Songzi Liu ◽  
Kai Zheng
Keyword(s):  
Systematic Review ◽  
Significant Variation ◽  
Clinical Documentation ◽  
Healthcare Organizations ◽  
Screening Process ◽  
Patient Consent ◽  
Exam Room ◽  
Meta Analyses ◽  
Lab Test ◽  
Medical Scribes

Abstract Objective Use of medical scribes reduces clinician burnout by sharing the burden of clinical documentation. However, medical scribes are cost-prohibitive for most settings, prompting a growing interest in developing ambient, speech-based technologies capable of automatically generating clinical documentation based on patient–provider conversation. Through a systematic review, we aimed to develop a thorough understanding of the work performed by medical scribes in order to inform the design of such technologies. Materials and Methods Relevant articles retrieved by searching in multiple literature databases. We conducted the screening process following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) in guidelines, and then analyzed the data using qualitative methods to identify recurring themes. Results The literature search returned 854 results, 65 of which met the inclusion criteria. We found that there is significant variation in scribe expectations and responsibilities across healthcare organizations; scribes also frequently adapt their work based on the provider’s style and preferences. Further, scribes’ job extends far beyond capturing conversation in the exam room; they also actively interact with patients and the care team and integrate data from other sources such as prior charts and lab test results. Discussion The results of this study provide several implications for designing technologies that can generate clinical documentation based on naturalistic conversations taking place in the exam room. First, a one-size-fits-all solution will be unlikely to work because of the significant variation in scribe work. Second, technology designers need to be aware of the limited role that their solution can fulfill. Third, to produce comprehensive clinical documentation, such technologies will likely have to incorporate information beyond the exam room conversation. Finally, issues of patient consent and privacy have yet to be adequately addressed, which could become paramount barriers to implementing such technologies in realistic clinical settings. Conclusions Medical scribes perform complex and delicate work. Further research is needed to better understand their roles in a clinical setting in order to inform the development of speech-based clinical documentation technologies.

A Systematic Review of Child to Parent Violence Interventions

2021 ◽  
pp. 152483802110536
Author(s):  
Chye Toole-Anstey ◽  
Lynne Keevers ◽  
Michelle L Townsend
Keyword(s):  
Systematic Review ◽  
Full Text ◽  
Assessment Tool ◽  
Inclusion Criteria ◽  
Screening Process ◽  
Conceptual Clarity ◽  
Research Questions ◽  
Meta Analyses ◽  
Two Stages ◽  
Design And Methods

Objective: To identify, appraise and synthesize research on the interventions used in child to parent violence. Method: A systematic literature review was conducted using the electronic databases of PsycINFO, Scopus, Web of Science and CINAHL Full Text. Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, three authors conducted the screening process which was implemented in two stages including screening the title and abstract, followed by screening the full text. Papers were assessed for quality using the Mixed Methods Assessment Tool. The search identified 727 studies which met the inclusion criteria, deduplication resulted in 525 number for review, with 8 articles included in the review. Results: This review identifies six themes from the six unique interventions included to address the research questions: How do practitioners effectively support families experiencing child-to-parent violence? The six themes are: Conceptualising the violence; Assessment of needs and risks; Intervention types and settings; Program techniques and components of interventions; Intervention outcomes and effectiveness; and Research design and methods. Three narratives were iteratively developed from these themes which highlight the main findings of the review: importance of the practitioner and their skills; conceptual clarity of CPV; and CPV interventions. Conclusions: The findings from this systematic review identifies the need for further research into child to parent violence including what makes interventions effective, what needs and outcomes the interventions are addressing, and the implications of classifications of this violence.

scholarly journals Denervation as a Treatment for Arthritis of the Hands: A Systematic Review of the Current Literature

Hand ◽  
2021 ◽  
pp. 155894472199425
Author(s):  
Sarah L. Zhu ◽  
Brian Chin ◽  
Mohamed Sarraj ◽  
Eugene Wang ◽  
Emily E. Dunn ◽  
...  
Keyword(s):  
Systematic Review ◽  
Hand Function ◽  
Case Series ◽  
Pooled Analysis ◽  
Postoperative Recovery ◽  
Sensory Loss ◽  
Process Data ◽  
Screening Process ◽  
Surgical Interventions ◽  
Meta Analyses

Joint denervation has been proposed as a less invasive option for surgical management of hand arthritis that preserves joint anatomy while treating pain and decreasing postoperative recovery times. The purpose of this systematic review was to investigate the efficacy and safety of surgical joint denervation for osteoarthritis in the joints of the hand. EMBASE, MEDLINE, and PubMed databases were searched from January 2000 to March 2019. Studies of adult patients with rheumatoid arthritis or osteoarthritis of the hand who underwent joint denervation surgery were included. Two reviewers performed the screening process, data abstraction, and risk of bias assessment (Methodological Index for Non-Randomized Studies). This review followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and was registered with PROSPERO (#125811). Ten studies were included, 9 case series and 1 cohort study, with a total of 192 patients. In all studies, joint denervation improved pain and hand function at follow-up (M = 36.8 months, range = 3-90 months). Pooled analysis of 3 studies on the first carpometacarpal joint showed a statistically significant ( P < .001) reduction in pain scores from baseline (M = 6.61 ± 2.03) to postoperatively (M = 1.69 ± 1.27). The combined complication rate was 18.8% (n = 36 of 192), with neuropathic pain or unintended sensory loss (8.8%, n = 17 of 192) being the most common. This review suggests that denervation may be an effective and low-morbidity procedure for treating arthritis of the hand. Prospective, comparative studies are required to further understand the outcomes of denervation compared with traditional surgical interventions.

scholarly journals Protocol of a Systematic Review on Telemedicine Solutions in COVID-19 Pandemic

2021 ◽  
Vol 10 (1) ◽  
pp. 96
Author(s):  
Saeid Eslami ◽  
Raheleh Ganjali
Keyword(s):  
Systematic Review ◽  
Decision Makers ◽  
World Health ◽  
Future Health ◽  
Screening Process ◽  
Review Study ◽  
Health Organization ◽  
Meta Analyses ◽  
Abstract Screening ◽  
Respiratory Droplets

Introduction: On March 20, 2020, the World Health Organization (WHO) announced the spread of SARS-CoV-2 infection in most countries worldwide as a pandemic. COVID-19 is mainly disseminated through human-to-human transmission route via direct contact and respiratory droplets. Telehealth and/or telemedicine technologies are beneficial methods that could be employed to deal with pandemic situation of communicable infections. The purpose of this proposed systematic review study is to sum up the functionalities, applications, and technologies of telemedicine during COVID-19 outbreak.Material and Methods: This review will be carried out in accordance with the Cochrane Handbook and PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) reporting guidelines. PubMed and Scopus databases were searched for related articles. Randomized and non-randomized controlled trials published in English in scientific journals were identified to be evaluated for eligibility. Articles conducted on telemedicine services (TMS) during COVID-19 outbreak (2019-2020) were identified to be evaluated.Results: The literature search for related articles in PubMed and Scopus databases led to the identification and retrieval of a total of 1118 and 485 articles, respectively. After eliminating duplicate articles, title and abstract screening process was performed for the remaining 1440 articles. The current study findings are anticipated to be used as a guide by researchers, decision makers, and managers to design, implement, and assess TMS during COVID-19 crisis.Conclusion: As far as we know, this systematic review is conducted to comprehensively evaluate TM methods and technologies developed with the aim of controlling and managing COVID-19 pandemic. This study highlights important applications of telemedicine in pandemic conditions, which could be employed by future health systems in controlling and managing communicable infections when an outbreak occurs.

scholarly journals Kidney Complications of COVID-19: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 21 (1) ◽  
pp. e00503-e00503
Author(s):  
Naser Nasiri ◽  
Shoboo Rahmati ◽  
Abbas Etminan ◽  
Hamid Sharifi ◽  
Azam Bazrafshan ◽  
...  
Keyword(s):  
Systematic Review ◽  
Data Extraction ◽  
Meta Analysis ◽  
Kidney Injury ◽  
Process Data ◽  
Screening Process ◽  
Cross Sectional ◽  
Normal Ranges ◽  
Pooled Prevalence ◽  
Meta Analyses

Background: Some patients with coronavirus disease 2019 (COVID-19) have been reported to have developed mild to severe kidney injuries. The current systematic review and meta-analysis was carried out to estimate the prevalence and incidence of acute kidney injury (AKI) among COVID-19 patients. Study design: A systematic review and meta-analysis Methods: PubMed, Embase, Scopus, Web of Science, and MedRxiv databases were searched from December 1, 2019, up to July 27, 2020. Two independent co-authors completed the screening process, data extraction, and quality assessment of the retrieved records. Random-effects meta-analyses were used to determine the pooled prevalence and 95% confidence interval (CI) of AKI among COVID-19 patients. Results: Out of 2,332 unique identified records, 51 studies were included in the review. Overall, the studies were carried out on 25,600 patients. A total of 6,505 patients (in 18 cross-sectional studies) were included to estimate the pooled prevalence of AKI, and 18,934 patients (in 27 cohort studies) were included to determine the pooled incidence of AKI. The pooled prevalence of AKI was estimated as 10.08% (95% CI: 4.59, 17.32; I 2=98.56%; P<0.001). Furthermore, the pooled incidence of AKI was 12.78% (95% CI: 7.38, 19.36; I 2=99.27%; P<0.001). The mean (95% CI) values of serum creatinine (SCr), blood urea nitrogen (BUN), potassium, and sodium were 76.10 (69.36, 82.84), 4.60 (4.04, 5.30), 3.94 (3.78, 4.11), and 139.30 (138.26, 140.36) mmol/L, respectively. Conclusions: The AKI is a considerable complication among COVID-19 patients and should be screened for on clinical examinations. The BUN, SCr, potassium, and sodium levels were within the normal ranges.

scholarly journals Measuring the impact of screening automation on meta-analyses of diagnostic test accuracy

2019 ◽  
Vol 8 (1) ◽  
Author(s):  
Christopher R. Norman ◽  
Mariska M. G. Leeflang ◽  
Raphaël Porcher ◽  
Aurélie Névéol
Keyword(s):  
Systematic Review ◽  
Diagnostic Test ◽  
Systematic Reviews ◽  
Estimation Error ◽  
Meta Analysis ◽  
Diagnostic Test Accuracy ◽  
Test Accuracy ◽  
Screening Process ◽  
Meta Analyses ◽  
The Impact

Abstract Background The large and increasing number of new studies published each year is making literature identification in systematic reviews ever more time-consuming and costly. Technological assistance has been suggested as an alternative to the conventional, manual study identification to mitigate the cost, but previous literature has mainly evaluated methods in terms of recall (search sensitivity) and workload reduction. There is a need to also evaluate whether screening prioritization methods leads to the same results and conclusions as exhaustive manual screening. In this study, we examined the impact of one screening prioritization method based on active learning on sensitivity and specificity estimates in systematic reviews of diagnostic test accuracy. Methods We simulated the screening process in 48 Cochrane reviews of diagnostic test accuracy and re-run 400 meta-analyses based on a least 3 studies. We compared screening prioritization (with technological assistance) and screening in randomized order (standard practice without technology assistance). We examined if the screening could have been stopped before identifying all relevant studies while still producing reliable summary estimates. For all meta-analyses, we also examined the relationship between the number of relevant studies and the reliability of the final estimates. Results The main meta-analysis in each systematic review could have been performed after screening an average of 30% of the candidate articles (range 0.07 to 100%). No systematic review would have required screening more than 2308 studies, whereas manual screening would have required screening up to 43,363 studies. Despite an average 70% recall, the estimation error would have been 1.3% on average, compared to an average 2% estimation error expected when replicating summary estimate calculations. Conclusion Screening prioritization coupled with stopping criteria in diagnostic test accuracy reviews can reliably detect when the screening process has identified a sufficient number of studies to perform the main meta-analysis with an accuracy within pre-specified tolerance limits. However, many of the systematic reviews did not identify a sufficient number of studies that the meta-analyses were accurate within a 2% limit even with exhaustive manual screening, i.e., using current practice.

scholarly journals A Systematic Review of the Quality of Reporting in Mathematics Meta-Analyses for Students with or at Risk of Disabilities Coding Protocol

2021 ◽  
Author(s):  
Gena Nelson
Keyword(s):  
Systematic Review ◽  
At Risk ◽  
Special Education ◽  
Meta Analysis ◽  
Grey Literature ◽  
Outcome Variable ◽  
Quality Of Reporting ◽  
Mathematics Interventions ◽  
Screening Process ◽  
Meta Analyses

The purpose of this document is to provide readers with the coding protocol that authors used to code 22 meta-analyses focused on mathematics interventions for students with or at-risk of disabilities. The purpose of the systematic review was to evaluate reporting quality in meta-analyses focused on mathematics interventions for students with or at risk of disabilities. To identify meta-analyses for inclusion, we considered peer-reviewed literature published between 2000 and 2020; we searched five education-focused electronic databases, scanned the table of contents of six special education journals, reviewed the curriculum vitae of researchers who frequently publish meta-analyses in mathematics and special education, and scanned the reference lists of meta-analyses that met inclusion criteria. To be included in this systematic review, meta-analyses must have reported on the effectiveness of mathematics-focused interventions, provided a summary effect for a mathematics outcome variable, and included school-aged participants with or at risk of having a disability. We identified 22 meta-analyses for inclusion. We coded each meta-analysis for 53 quality indicators (QIs) across eight categories based on recommendations from Talbott et al. (2018). Overall, the meta-analyses met 61% of QIs and results indicated that meta-analyses most frequently met QIs related to providing a clear purpose (95%) and data analysis plan (77%), whereas meta-analyses typically met fewer QIs related to describing participants (39%) and explaining the abstract screening process (48%). We discuss the variation in QI scores within and across the quality categories and provide recommendations for future researchers so that reporting in meta-analyses may be enhanced. Limitations of the current study are that grey literature was not considered for inclusion and that only meta-analyses were included; this limits the generalizability of the results to other research syntheses (e.g., narrative reviews, systematic reviews) and publication types (e.g., dissertations).

Psychological and Cognitive Aspects of Borderline Intellectual Functioning

2017 ◽  
Vol 22 (3) ◽  
pp. 159-166 ◽  
Author(s):  
Bastianina Contena ◽  
Stefano Taddei
Keyword(s):  
Quality Of Life ◽  
Systematic Review ◽  
Intellectual Functioning ◽  
Clinical Impact ◽  
Review Of The Literature ◽  
Borderline Intellectual Functioning ◽  
General Quality ◽  
Meta Analyses ◽  
Over Time

Abstract. Borderline Intellectual Functioning (BIF) refers to a global IQ ranging from 71 to 84, and it represents a condition of clinical attention for its association with other disorders and its influence on the outcomes of treatments and, in general, quality of life and adaptation. Furthermore, its definition has changed over time causing a relevant clinical impact. For this reason, a systematic review of the literature on this topic can promote an understanding of what has been studied, and can differentiate what is currently attributable to BIF from that which cannot be associated with this kind of intellectual functioning. Using Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) criteria, we have conducted a review of the literature about BIF. The results suggest that this condition is still associated with mental retardation, and only a few studies have focused specifically on this condition.

Vaccination in childhood and the risk of childhood cancer – a systematic review and meta-analyses

2017 ◽  
Author(s):  
P Sadre Dadras ◽  
LK Brackmann ◽  
I Langner ◽  
U Haug ◽  
W Ahrens ◽  
...  
Keyword(s):  
Systematic Review ◽  
Childhood Cancer ◽  
Meta Analyses
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