scholarly journals Considerations of Privacy and Confidentiality in Developing a Clinical Support Tool for Adolescent Tobacco Prevention: Qualitative Study

10.2196/12406 ◽  
2019 ◽  
Vol 3 (2) ◽  
pp. e12406
Author(s):  
Ryan P Theis ◽  
Ali M Malik ◽  
Lindsay A Thompson ◽  
Elizabeth A Shenkman ◽  
Lori Pbert ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Tobacco Prevention ◽  
Support Tool ◽  
Clinical Support ◽  
Privacy And Confidentiality ◽  
Clinical Support Tool

Considerations of Privacy and Confidentiality in Developing a Clinical Support Tool for Adolescent Tobacco Control: A Qualitative Study (Preprint)

2018 ◽  
Author(s):  
Ryan P Theis ◽  
Ali M Malik ◽  
Lindsay A Thompson ◽  
Elizabeth A Shenkman ◽  
Lori Pbert ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Focus Groups ◽  
Tobacco Use ◽  
Primary Objective ◽  
Barriers And Facilitators ◽  
Tobacco Prevention ◽  
Support Tool ◽  
Clinical Support ◽  
Support Tools ◽  
Privacy And Confidentiality

BACKGROUND Electronic clinical support tools show promise for facilitating tobacco screening and counseling in adolescent well-care. However, the application of support tools in pediatric settings has not been thoroughly studied. Successfully implementing support tools in local settings requires an understanding of barriers and facilitators from the perspective of both patients and providers. OBJECTIVE This paper presents findings of a qualitative study conducted to inform the development and implementation of a support tool for adolescent tobacco screening and counseling in three pediatric clinics in North Florida. The primary objective of the study was to test and collect information needed to refine a tablet-based support tool with input from patients and providers in the study clinics. METHODS A tablet prototype was designed to collect information from adolescents on tobacco susceptibility and use prior to their well-care visit and to present tobacco prevention videos based on their responses. Information collected from adolescents by the support tool would be available to providers during the visit to facilitate and streamline tobacco use assessment and counseling components of well-care. Focus groups with providers and staff from three pediatric clinics (N = 24) identified barriers and facilitators to implementation of the support tool. In-depth interviews with racially/ethnically diverse adolescent patients who screened as susceptible to tobacco use (N = 16) focused on acceptability and usability of the tool. All focus groups and interviews were audio recorded and transcribed for team-based coding using grounded theory. RESULTS Privacy and confidentiality of information emerged as a salient theme. Both groups expressed concerns that the tool’s audio and visual components would impede privacy, and that parents may read their child’s responses or exert control over the process. Nearly all adolescents stated they would be comfortable with the option to complete the tool at home via a web-portal. Most adolescents stated they would feel comfortable discussing tobacco with their doctor. Adolescent interviews elicited three themes that added context to perspectives on confidentiality and had practical implications for implementation: (1) purity – an expressed lack of concern for confidentiality among adolescents with no reported history of tobacco use; (2) steadfast honesty – a commitment to being honest with parents and providers about tobacco use, regardless of the situation; and (3) indifference – a perceived lack of relevance of confidentiality, based on the premise that others will “find out anyway” if adolescents are using tobacco. CONCLUSIONS This study informed several modifications to the intervention to address confidentiality and introduce efficiency to well-care visits. The support tool was integrated into the electronic health records system used by the study clinics, and modified to offer videos to all adolescents regardless of their tobacco use or susceptibility. Future studies will further test the acceptability of the intervention in practice.

scholarly journals Stakeholder Engagement in Developing an Electronic Clinical Support Tool for Tobacco Prevention in Adolescent Primary Care

Children ◽  
2018 ◽  
Vol 5 (12) ◽  
pp. 170 ◽  
Author(s):  
Ramzi G. Salloum ◽  
Ryan P. Theis ◽  
Lori Pbert ◽  
Matthew J. Gurka ◽  
Maribeth Porter ◽  
...  
Keyword(s):  
Primary Care ◽  
Stakeholder Engagement ◽  
Critical Role ◽  
Implementation Process ◽  
Feasibility Trial ◽  
Tobacco Prevention ◽  
Clinical Workflow ◽  
Support Tool ◽  
Clinical Support ◽  
Clinical Support Tool

Following guideline recommendations to promote tobacco prevention in adolescent primary care, we developed a patient-facing clinical support tool. The electronic tool screens patients for use and susceptibility to conventional and alternative tobacco products, and promotes patient–provider communication. The purpose of this paper is to describe the iterative stakeholder engagement process used in the development of the tool. During the pre-testing phase, we consulted with scientists, methodologists, clinicians, and Citizen Scientists. Throughout the development phase, we engaged providers from three clinics in focus groups. Usability testing was conducted via in-depth, cognitive interviewing of adolescent patients. Citizen Scientists (n = 7) played a critical role in the final selection of educational content and interviewer training by participating in mock-up patient interviews. Cognitive interviews with patients (n = 16) ensured that systems were in place for the feasibility trial and assessed ease of navigation. Focus group participants (n = 24) offered recommendations for integrating the tool into clinical workflow and input on acceptability and appropriateness, and anticipated barriers and facilitators for adoption and feasibility. Engaging key stakeholders to discuss implementation outcomes throughout the implementation process can improve the quality, applicability, and relevance of the research, and enhance implementation success.

scholarly journals Artificial intelligence: a new clinical support tool for stress echocardiography

2018 ◽  
Vol 15 (8) ◽  
pp. 513-515 ◽  
Author(s):  
Maryam Alsharqi ◽  
Ross Upton ◽  
Angela Mumith ◽  
Paul Leeson
Keyword(s):  
Artificial Intelligence ◽  
Stress Echocardiography ◽  
Support Tool ◽  
Clinical Support ◽  
Clinical Support Tool

P1-576: A RISK FACTOR-BASED CLINICAL SUPPORT TOOL TO SCREEN FOR PRE-DEATH GRIEF IN FAMILY CAREGIVERS OF PERSONS WITH DEMENTIA

2006 ◽  
Vol 14 (7S_Part_10) ◽  
pp. P556-P557
Author(s):  
Tau Ming Liew ◽  
Bee Choo Tai ◽  
Philip Yap ◽  
Gerald Choon-Huat Koh
Keyword(s):  
Risk Factor ◽  
Family Caregivers ◽  
Support Tool ◽  
Clinical Support ◽  
Clinical Support Tool

scholarly journals Standard blood laboratory values as a clinical support tool to distinguish between SARS-CoV-2 positive and negative patients

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Rainer Thell ◽  
Jascha Zimmermann ◽  
Marton Szell ◽  
Sabine Tomez ◽  
Philip Eisenburger ◽  
...  
Keyword(s):  
Negative Likelihood Ratio ◽  
Blood Parameters ◽  
Support Tool ◽  
Laboratory Parameters ◽  
Reactive Protein ◽  
Diagnostic Potential ◽  
Clinical Support ◽  
Post Test ◽  
Sensitivity Specificity ◽  
Clinical Support Tool

AbstractStandard blood laboratory parameters may have diagnostic potential, if polymerase-chain-reaction (PCR) tests are not available on time. We evaluated standard blood laboratory parameters of 655 COVID-19 patients suspected to be infected with SARS-CoV-2, who underwent PCR testing in one of five hospitals in Vienna, Austria. We compared laboratory parameters, clinical characteristics, and outcomes between positive and negative PCR-tested patients and evaluated the ability of those parameters to distinguish between groups. Of the 590 patients (20–100 years, 276 females and 314 males), 208 were PCR-positive. Positive compared to negative PCR-tested patients had significantly lower levels of leukocytes, neutrophils, basophils, eosinophils, lymphocytes, neutrophil-to-lymphocyte ratio, monocytes, and thrombocytes; while significantly higher levels were detected with erythrocytes, hemoglobin, hematocrit, C-reactive-protein, ferritin, activated-partial-thromboplastin-time, alanine-aminotransferase, aspartate-aminotransferase, lipase, creatine-kinase, and lactate-dehydrogenase. From all blood parameters, eosinophils, ferritin, leukocytes, and erythrocytes showed the highest ability to distinguish between COVID-19 positive and negative patients (area-under-curve, AUC: 72.3–79.4%). The AUC of our model was 0.915 (95% confidence intervals, 0.876–0.955). Leukopenia, eosinopenia, elevated erythrocytes, and hemoglobin were among the strongest markers regarding accuracy, sensitivity, specificity, positive and negative predictive value, positive and negative likelihood ratio, and post-test probabilities. Our findings suggest that especially leukopenia, eosinopenia, and elevated hemoglobin are helpful to distinguish between COVID-19 positive and negative tested patients.

scholarly journals Standard Blood Laboratory Values As A Clinical Support Tool to Distinguish Between SARS-CoV-2 Positive and Negative Patients

2020 ◽  
Author(s):  
Rainer Thell ◽  
Jascha Zimmermann ◽  
Marton Szell ◽  
Sabine Tomez ◽  
Philip Eisenburger ◽  
...  
Keyword(s):  
Negative Likelihood Ratio ◽  
Blood Parameters ◽  
Support Tool ◽  
Laboratory Parameters ◽  
Reactive Protein ◽  
Diagnostic Potential ◽  
Clinical Support ◽  
Post Test ◽  
Sensitivity Specificity ◽  
Clinical Support Tool

Abstract Standard blood laboratory parameters may have diagnostic potential, if polymerase-chain-reaction (PCR) tests are not available on time. We evaluated standard blood laboratory parameters of 655 COVID-19 patients suspected to be infected with SARS-CoV-2, who underwent PCR testing in one of five hospitals in Vienna, Austria. We compared laboratory parameters, clinical characteristics, and outcomes between positive and negative PCR-tested patients and evaluated the ability of those parameters to distinguish between groups. Of the 590 patients (20-100years, 276 females and 314 males), 208 were PCR-positive. Positive compared to negative PCR-tested patients had significantly lower levels of leukocytes, neutrophils, basophils, eosinophils, lymphocytes, neutrophil-to-lymphocyte ratio, monocytes, and thrombocytes; while significantly higher levels were detected with erythrocytes, hemoglobin, hematocrit, C-reactive-protein, ferritin, activated-partial-thromboplastin-time, alanine-aminotransferase, aspartate-aminotransferase, lipase, creatine-kinase, and lactate-dehydrogenase. From all blood parameters, eosinophils, ferritin, leukocytes, and erythrocytes showed the highest ability to distinguish between COVID-19 positive and negative patients (area-under-curve: 72.3-79.4%). Leukopenia, eosinopenia, elevated erythrocytes, and hemoglobin were among the strongest markers regarding accuracy, sensitivity, specificity, positive and negative predictive value, positive and negative likelihood ratio, and post-test probabilities. Our findings suggest that especially leukopenia, eosinopenia, as well as elevated erythrocytes, hemoglobin, and ferritin are helpful to distinguish between COVID-19 positive and negative tested patients.

Sign in / Sign up

Export Citation Format

Share Document